Organization
SOUTHERN CALIFORNIA KIDNEY CONSULTANTS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH A GONZALEZ (ADMINISTRATOR)
(714) 636-2890
Entity
Organization
Contact information
Practice address
12665 GARDEN GROVE BLVD, STE 211, GARDEN GROVE, CA 92843-1901
(714) 636-2890
(714) 636-2909
Mailing address
12665 GARDEN GROVE BLVD, STE 211, GARDEN GROVE, CA 92843-1901
(714) 636-2890
(714) 636-2909
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G24122
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ75439Z
—
CA
Enumeration date
09/20/2006
Last updated
10/16/2018
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