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EL CAMINO RENAL MEDICAL GROUP INC NPI 1770560914


NPI Information

NPI: 1770560914
Provider Name: EL CAMINO RENAL MEDICAL GROUP, INC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 05D0947530

Address:
515 SOUTH DR
SUITE 12
MOUNTAIN VIEW, CA
ZIP 94040
Phone: (650) 988-7944
Get Directions

EL CAMINO RENAL MEDICAL GROUP, INC is a nephrology internal medicine in Mountain View, 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. EL CAMINO RENAL MEDICAL GROUP, INC NPI is 1770560914. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

515 SOUTH DR
SUITE 12
MOUNTAIN VIEW, CA
ZIP 94040-204
Phone: (650) 988-7944
Fax: (650) 964-3608

The provider's authorized official is Brian James Carrie .
The authorized official title is Director and has the following contact phone number (650) 988-7944.

The CLIA number assigned to this NPI record is 05D0947530 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/29/2005 and was last updated on 10/31/2017.


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 MedicineNephrologyYes

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
1ZZZ77355ZMEDICAIDCALIFORNIA
21770560914MEDICARE PINCALIFORNIA
3ZZZ77355ZMEDICARE ID-TYPE UNSPECIFIED

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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