Organization
ANGEL KIDNEY CARE OF INGLEWOOD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAHRA TABASSIAN (OWNER)
(310) 671-2420
Entity
Organization
Contact information
Practice address
994 S LA BREA AVE, INGLEWOOD, CA 90301-3816
(310) 330-5665
(310) 330-8586
Mailing address
994 S LA BREA AVE, INGLEWOOD, CA 90301-3816
(310) 330-5665
(310) 330-8586
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245354687
—
CA
Enumeration date
03/19/2007
Last updated
12/23/2014
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