NEPHROLOGY ASSOCIATES MEDICAL GROUP, INC. (NPI# 1093264145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093264145 |
| Entity Type | Organization |
| Organization Name | NEPHROLOGY ASSOCIATES MEDICAL GROUP, INC. |
| Practice Address |
3660 Park Sierra Dr Ste 203 Riverside CA 92505-3071 |
| Mailing Address |
Po Box 54130 Los Angeles CA 90054-0130 |
| Practice Telephone | 9516873200 |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |
| Authorized Official Name | DR. CHAO HUANG SUN (CO OWNER) |
| Authorized Official Telephone | 9516873200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1447200126 | 05 | |
| CA | GR0071421 | 05 | |
| CA | GR71423 | 05 | |
| CA | GR0071422 | 05 | |
| CA | GR0071420 | 05 | |
| CA | GR0071424 | 05 |
| Street Address |
3660 PARK SIERRA DR STE 203 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92505-3071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205458460 | Mark Anthony Vargas | Behavioral Analyst | 94193 Flat Rock Dr Ste 220, Riverside, CA 92505 | 2020-05-11 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1588222087 | A Homecare Services, Inc | In Home Supportive Care | 4193 Flat Rock Road, Building 200 Suite 206, Riverside, CA 92505 | 2019-05-31 |
| 1609302397 | Tap Pharmacy, Inc. | Pharmacy | 4270 Riverwalk Pkwy Ste 102, Riverside, CA 92505 | 2017-05-02 |
| 1467998658 | Onofre Gascon | Behavior Technician | 11711 Collett Ave, #1614, Riverside, CA 92505 | 2017-01-11 |
| 1780038505 | Nash David Martinez | Emergency Medicine | 10800 Magnolia Ave Dept of Emergency Medicine, Kaiser Permanente Hospital, Riverside, CA 92505 | 2016-04-18 |
| 1447639901 | Jose Joel Manalese Dds Inc | Dentist | 3950 Pierce St., Suite L., Riverside, CA 92505 | 2015-05-29 |
| 1821493230 | Jean Huynh | Physician Assistant | 11725 State Ave., Suite 100, Riverside, CA 92505 | 2014-10-28 |
| 1003160649 | Elaf Farahat | Dietitian, Registered | 10800 Magnolia Avenue., Riverside, CA 92505 | 2012-11-05 |
| 1730458217 | Tammy Lynn Gilmore | Non-emergency Medical Transport (VAN) | 10770 Hole Avenue, 106, Riverside, CA 92505 | 2011-12-29 |
| Find all providers in zip 92505 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699383661 | Transgender Health and Wellness Center | Specialist | 6700 Indiana Ave Ste 252, Riverside, CA 92506-4264 | 2020-07-16 |
| 1295350668 | Bette Graff | Specialist | 4148 10th St, Riverside, CA 92501-3110 | 2020-06-11 |
| 1295275808 | Eastern Comprehensive Medical Services | Specialist | 106 Sheephill Rd, Riverside, CT 06878-1120 | 2017-03-01 |
| 1245778331 | Lynn Nevatt | Specialist | 3833 Jurupa Ave, Riverside, CA 92506-2221 | 2017-02-08 |
| 1639625247 | Dana Keim | Specialist | 6864 Indiana Ave Ste 104a, Riverside, CA 92506 | 2016-09-01 |
| 1720401615 | Matthew Martinez | Specialist | 8205 Coleman St, Riverside, CA 92504-3107 | 2014-01-28 |
| 1649512575 | Michael C Luciano | Specialist | 3120 Chicago Ave, Suite #170, Riverside, CA 92507-3490 | 2013-03-18 |
| 1508110461 | Luis Angel Calvillo Jr. | Specialist | 246 Plews Ct, Riverside, CA 92507-1100 | 2012-10-30 |
| 1639474513 | Jeanne Dunkel | Specialist | 3529 Hoover St, Riverside, CA 92504-3907 | 2011-01-24 |
| 1821271412 | Mario Carcamo Md Inc | Specialist | 4440 Brockton Ave Ste 420, Riverside, CA 92501-4026 | 2007-12-06 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.