HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES INC. (NPI# 1730646266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730646266 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES INC. |
| Practice Address |
11883 Amethyst Road Ste # 100 Victorville CA 92392-9224 |
| Mailing Address |
12675 Hesperia Road Victorville CA 92395-9224 |
| Practice Telephone | 7609982060 |
| Practice Fax Number | 9609982068 |
| Mailing Telephone | 9602413306 |
| Mailing Fax Number | 7602416243 |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |
| Authorized Official Name | MR. JAY E SHANKAR (CEO/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7602413306 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
11883 AMETHYST ROAD STE # 100 |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92392-9224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215568688 | Kristin Parris | Behavior Technician | 15490 Civic Drive, Victorville, CA 92392 | 2020-02-03 |
| 1366001604 | Pine Ridge Treatment Centers, Inc. | Substance Abuse Rehabilitation Facility | 15367 Bonanza Rd, Ste A, Victorville, CA 92392 | 2019-06-11 |
| 1851871289 | Betty A. Murphy, Lmft, Inc | Marriage & Family Therapist | 15437 Anacapa Rd. Ste 26, Victorville, CA 92392 | 2018-08-15 |
| 1104313402 | Jorge L Soler Iglesias | Nurse Practitioner | 12459 Cricket St., Victorville, CA 92392 | 2018-04-23 |
| 1689192049 | Jamesina Johns | Nurse Practitioner | 12127 Mall Blvd #148, Victorville, CA 92392 | 2017-09-06 |
| 1285151886 | Jasmin Sanchez | Behavioral Analyst | 13201 Eclipse Ave, Victorville, CA 92392 | 2017-08-24 |
| 1174049829 | Virginia Marshall | Behavioral Analyst | 13901 Amargosa Rd., Victorville, CA 92392 | 2017-08-15 |
| 1346781465 | San Bernardino Conty | Counselor | 15480 Ramona Ave., Victoville, CA 92392 | 2017-03-09 |
| 1841741279 | Lorinda Morreale | Marriage & Family Therapist | 15428 Civic Dr. Ste 200, Act Family Counseling, Victorville, CA 92392 | 2016-10-20 |
| 1235582404 | Greater Hope Foundation | Community/Behavioral Health | 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 | 2016-07-22 |
| Find all providers in zip 92392 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972919983 | Pooja Tanjavour | Internal Medicine | 12276 Hesperia Rd Ste D, Victorville, CA 92395-5838 | 2014-07-10 |
| 1306881099 | Hosameldin Madkour | Internal Medicine | 12675 Hesperia Rd, Victorville, CA 92395-5878 | 2006-06-18 |
| 1235127515 | Edgard Mario Vera Tapia | Internal Medicine | 17207 Jasmine St, 2, Victorville, CA 92395 | 2005-10-11 |
| 1801154380 | Opeyemi Oladele | Internal Medicine | 12675 Hesperia Rd, Victorville, CA 92395-5878 | 2012-05-02 |
| 1871734921 | Edgard M. Vera, Md,inc. | Internal Medicine | 17207 Jasmine St, 2, Victorville, CA 92395 | 2009-03-19 |
| 1992891956 | Sheila Cherian | Internal Medicine | 17207 Jasmine St, 2, Victorville, CA 92395 | 2006-10-05 |
| 1407865652 | High Desert Nephrology Medical Associates, Inc. | Internal Medicine | 12675 Hesperia Rd, Victorville, CA 92395-5878 | 2006-08-05 |
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|---|---|---|---|---|
| 1710585328 | Empire Medical Specialist | Internal Medicine | 28625 Quaint St, Agoura Hills, CA 91301-1735 | 2020-10-15 |
| 1538774989 | Modern Telehealth | Internal Medicine | 1509 Espinosa Cir, Palos Verdes Estates, CA 90274-1917 | 2020-09-12 |
| 1073137733 | Jafar Alsaid | Internal Medicine | 2009 Baywood Ln, Davis, CA 95618-0500 | 2020-05-29 |
| 1164041422 | Advanced Care Multispecialty Medical Group Apc | Internal Medicine | 13990 Bear Fence Court, Moorpark, CA 93021-5022 | 2020-04-15 |
| 1629600416 | Valley Kidney Medical Group Inc | Internal Medicine | 1646 E Herndon Ave Ste 106, Fresno, CA 93720-3380 | 2020-02-10 |
| 1437789278 | Spectrum Dialysis | Internal Medicine | 18040 Sherman Way Ste 220, Reseda, CA 91335-4631 | 2020-01-21 |
| 1932745007 | K Care Ipa | Internal Medicine | 18000 Studebaker Rd Ste 100, Cerritos, CA 90703-7929 | 2019-11-22 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
| 1295293363 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 220, Chico, CA 95928-8351 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | VICTORVILLE |
| Zip Code | 92392 |
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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.