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Organization
NEPHROLOGY ASSOCIATES MEDICAL GROUP, INC.
Active
Organization
NEPHROLOGY ASSOCIATES MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAO HUANG SUN (CO OWNER)
(951) 687-3200
Entity
Organization
Contact information
Practice address
3660 PARK SIERRA DR STE 203, RIVERSIDE, CA 92505-3071
(951) 687-3200
Mailing address
PO BOX 54130, LOS ANGELES, CA 90054-0130
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447200126
—
CA
05
—
GR0071420
—
CA
05
—
GR0071421
—
CA
05
—
GR0071422
—
CA
05
—
GR0071424
—
CA
05
—
GR71423
—
CA
Enumeration date
09/30/2016
Last updated
09/30/2016
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