Organization
L A COUNTY NEPHROLOGY ASSOCIATES A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDY MARINO (OFFICE MANAGER)
(323) 726-3868
Entity
Organization
Contact information
Practice address
3114 W BEVERLY BLVD, MONTEBELLO, CA 90640-2217
(323) 726-1317
(323) 726-3870
Mailing address
PO BOX 22036, BELFAST, ME 04915-4117
(323) 726-3868
(323) 726-3870
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A792790
—
CA
01
—
C13392
RAILROAD MEDICARE GROUP
CA
05
—
GR0052990
—
CA
05
—
GR0052991
—
CA
05
—
GR0052992
—
CA
01
—
ZZZ447842
BLUE SHIELD GROUP NUMBER
CA
Enumeration date
07/12/2006
Last updated
06/26/2024
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