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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