KIDNEY DISEASE MEDICAL GROUP INC NPI 1740392810

NPI Information

KIDNEY DISEASE MEDICAL GROUP INC is a specialist in Glendale, CA. The provider is 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. KIDNEY DISEASE MEDICAL GROUP INC NPI is 1740392810. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1505 WILSON TER
SUITE #155
GLENDALE, CA
ZIP 91206-071
Phone: (818) 500-4055
Fax: (818) 500-4065

The provider's authorized official is Dariush Arfaania .
The authorized official title is President Of The Group and has the following contact phone number (818) 500-4055.

The CLIA number assigned to this NPI record is 05D1092140 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 4/28/2014.

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:

Other Identifiers

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