Organization Active NPI

Kailash Dhamija Walk in Medical Care a Medical Corporation

  • General Practice Physician
  • Long Beach, CA
National Provider Identifier
1952583569
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A42292 Issued in CA
Legal business name
KAILASH DHAMIJA WALK IN MEDICAL CARE A MEDICAL CORPORATION
Practice address
3760 Atlantic Ave # a
Long Beach, CA 90807-3409
Phone
(562) 595-7467
Fax
(562) 988-0276
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kailash R Dhamija, MD
Title
Medical Director
Phone
(562) 595-7467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A42292 CA Primary

Addresses

Primary practice location

3760 Atlantic Ave # a
Long Beach, CA 90807-3409

Mailing address

3760 Atlantic Ave # a
Long Beach, CA 90807-3409
Phone (562) 595-7467

Other identifiers 1

IdentifierTypeStateIssuer
05D1073086OtherCACLIA

Other names 1

  • WALK IN MEDICAL CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090724000624 CA Part B Supplier - Clinic/Group Practice 5395756860 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Artesia, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3760 Atlantic Ave
#A
Long Beach, CA 90807
Phone (562) 595-7467

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1952583569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 ATLANTIC AVE # A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073409",
            "telephone_number": "562-595-7467",
            "fax_number": "562-988-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 ATLANTIC AVE # A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073409",
            "telephone_number": "562-595-7467",
            "fax_number": "562-988-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAILASH DHAMIJA WALK IN MEDICAL CARE A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "DHAMIJA",
        "authorized_official_first_name": "KAILASH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-595-7467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A42292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1073086",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALK IN MEDICAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.