NPIMap

Organization Active NPI

Pacific Advanced Kidney Solutions Inc

  • Specialist
  • Torrance, CA
National Provider Identifier
1992160501
Registry record updated Dec 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PACIFIC ADVANCED KIDNEY SOLUTIONS INC
Practice address
20911 Earl St
Suite 200
Torrance, CA 90503-4352
Phone
(310) 488-4232
NPI assigned
Dec 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2015

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

Authorized official

Name
Firooz Pak, M.D.NPI 1568462364
Title
Owner
Phone
(310) 488-4232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

20911 Earl St
Suite 200
Torrance, CA 90503-4352

Mailing address

PO Box 2350
Manhattan Beach, CA 90267-2350
Phone (310) 488-4232

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160908002413 CA Part B Supplier - Clinic/Group Practice 0547556003 Receives reassigned benefits from 8 practitioners
Practice locations: Los Angeles, CA; Torrance, CA

National Provider Directory

National Provider Directory

Locations

5240 Sepulveda Blvd
Culver City, CA 90230
Phone (310) 391-7266

4035 Grand View Blvd
Los Angeles, CA 90066
Phone (310) 390-9506

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1450915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450915200000",
    "number": "1992160501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2350",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902672350",
            "telephone_number": "310-488-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20911 EARL ST",
            "address_2": "SUITE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034352",
            "telephone_number": "310-488-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ADVANCED KIDNEY SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-24",
        "last_updated": "2015-12-24",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "FIROOZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-488-4232",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.