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Organization
WEST COAST RENAL MEDICAL GROUP, INC
Active
Organization
WEST COAST RENAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIESHI YAN M.D. (PRESIDENT)
(818) 718-2301
Entity
Organization
Contact information
Practice address
2925 SYCAMORE DR, SUITE 160, SIMI VALLEY, CA 93065-1207
(805) 584-0177
(805) 584-1179
Mailing address
13990 BEAR FENCE CT, MOORPARK, CA 93021-5022
(818) 718-2301
(818) 718-2311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
12/19/2017
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