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COAST NEPHROLOGY MEDICAL GROUP INC. NPI 1053317826


NPI Information

NPI: 1053317826
Provider Name: COAST NEPHROLOGY MEDICAL GROUP INC.
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 05D0554309

Address:
3780 KILROY AIRPORT WAY
STE 115
LONG BEACH, CA
ZIP 90806
Phone: (562) 595-7426
Get Directions

COAST NEPHROLOGY MEDICAL GROUP INC. is a nephrology internal medicine in Long Beach, CA. The provider is 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. COAST NEPHROLOGY MEDICAL GROUP INC. NPI is 1053317826. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3780 KILROY AIRPORT WAY
STE 115
LONG BEACH, CA
ZIP 90806-458
Phone: (562) 595-7426
Fax: (562) 989-3054

The provider's authorized official is Alan I Erlbaum .
The authorized official title is President and has the following contact phone number (562) 595-7426.

The CLIA number assigned to this NPI record is 05D0554309 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/24/2005 and was last updated on 8/2/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrologyBU94027460CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0055750MEDICAIDCALIFORNIA
2W12019AMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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