Usrc Pacific Gateway LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

USRC PACIFIC GATEWAY LLC

Practice address

1149 W 190TH St Ste 1004
Gardena, CA 90248-4333

Phone

(310) 965-0830

NPI assigned

Feb 27, 2018

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

Chairman

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Pacific Gateway Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

USRC Pacific GatewayCCN 052821

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Feb 4, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

21

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Locations

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Philip W Chung, M.D.

  • Nephrology Physician
  • Torrance, CA
  • NPI 1003881889

  Dialysis facility

  Care Compare affiliation Name & address match
• Omer Khan, MD

  • Nephrology Physician
  • Torrance, CA
  • NPI 1396036646

  Dialysis facility

  Care Compare affiliation Name & address match
• Edgar Allan Musngi, M.D.

  • Nephrology Physician
  • Torrance, CA
  • NPI 1871523563

  Dialysis facility

  Care Compare affiliation Name & address match
• Wayne K Tsang, M.D.

  • Nephrology Physician
  • Torrance, CA
  • NPI 1588707194

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1962903690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 W 190TH ST STE 1004",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484333",
            "telephone_number": "310-965-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC PACIFIC GATEWAY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Pacific Gateway Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos Ricardo Urizar
• Jacqueline Rosario Urquidez, BA
• US Health Services
• Aniya Allyse Usher
• Usrc Gardena, LLC
• Kyla Utzinger
• Mark Daniel Legaspi Uy
• Gary James Uyeda, D.D.S.
• VA Greater Los Angeles Healthcare System
• Julian Oscar Vaca

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Gardena, CA
• Providers in Gardena, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.