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WELLCARE MEDICAL GROUP NPI 1225314107


NPI Information

NPI: 1225314107
Provider Name: WELLCARE MEDICAL GROUP

Doing Business As: WELLCARE LA MEDICAL GROUP

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 05D0713358

Address:
16415 S COLORADO AVENUE
SUITE 208
PARAMOUNT, CA
ZIP 90723
Phone: (562) 531-0015
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WELLCARE MEDICAL GROUP is a nephrology internal medicine in Paramount, 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. WELLCARE MEDICAL GROUP NPI is 1225314107. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wellcare La Medical Group.

The provider's business location address is:

16415 S COLORADO AVENUE
SUITE 208
PARAMOUNT, CA
ZIP 90723-054
Phone: (562) 531-0015
Fax: (562) 531-4856

The provider's authorized official is Richard W Lee .
The authorized official title is Physician and has the following contact phone number (562) 531-0015.

The CLIA number assigned to this NPI record is 05D0713358 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/24/2011 and was last updated on 1/31/2013.


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
1207Q00000XFamily MedicineCALIFORNIANo
2207RN0300XInternal MedicineNephrologyA85452CALIFORNIAYes

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: 11/14/2023

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