PACIFIC NEPHROLOGY MEDICAL GROUP NPI 1922013515

NPI Information

  • NPI: 1922013515
  • Provider Name: PACIFIC NEPHROLOGY MEDICAL GROUP
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • CLIA Number: 05D0705927
  • Address: 323 N PRAIRIE AVE # 334
    INGLEWOOD, CA
    ZIP 90301
  • Phone: (310) 674-8600

Map and Directions

Get Directions

NPI Details

PACIFIC NEPHROLOGY MEDICAL GROUP is a nephrology internal medicine in Inglewood, 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. PACIFIC NEPHROLOGY MEDICAL GROUP NPI is 1922013515. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

323 N PRAIRIE AVE # 334
INGLEWOOD, CA
ZIP 90301-502
Phone: (310) 674-8600
Fax: (310) 671-9883

The provider's authorized official is Michael Dylan Healy .
The authorized official title is Partner and has the following contact phone number (310) 674-8600.

The CLIA number assigned to this NPI record is 05D0705927 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 9/21/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1W5961AMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2GR0000360MEDICAIDCALIFORNIA

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI