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Organization
KIDNEY SPECIALISTS MEDICAL CORPORATION
Active
Organization
KIDNEY SPECIALISTS MEDICAL CORPORATION
Active
Other names
Southern Calif. Nephrologists Medical Associates Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DORSA F. MARYSKA (M.D./PRESIDENT)
(323) 722-7418
Entity
Organization
Contact information
Practice address
101 E BEVERLY BLVD, SUITE #304, MONTEBELLO, CA 90640-4300
(323) 722-7418
(323) 722-7894
Mailing address
101 E BEVERLY BLVD, SUITE #304, MONTEBELLO, CA 90640-4300
(323) 722-7418
(323) 722-7894
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0080920
—
CA
Enumeration date
08/31/2006
Last updated
12/08/2023
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