Organization
KIDNEY CARE A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIALICK TABIBIAN (MEDICAL DOCTOR)
(310) 914-9150
Entity
Organization
Contact information
Practice address
8540 S SEPULVEDA BLVD STE 1100, LOS ANGELES, CA 90045-3819
(310) 914-9150
(310) 914-9705
Mailing address
PO BOX 25427, LOS ANGELES, CA 90025-0427
(310) 914-9150
(310) 914-9705
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A47826
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A478261
—
CA
Enumeration date
08/17/2006
Last updated
08/22/2020
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