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Organization
PACIFIC NEPHROLOGY MEDICAL GROUP
Active
Organization
PACIFIC NEPHROLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DYLAN HEALY M.D. (PARTNER)
(310) 674-8600
Entity
Organization
Contact information
Practice address
323 N PRAIRIE AVE # 334, INGLEWOOD, CA 90301-4502
(310) 674-8600
(310) 671-9883
Mailing address
323 N PRAIRIE AVE # 334, INGLEWOOD, CA 90301-4502
(310) 674-8600
(310) 671-9883
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0000360
—
CA
Enumeration date
07/30/2006
Last updated
09/21/2009
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