Organization
CENTRO DE CUIDADO RENAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUNDA JAHROMI (CORP SECRETARY)
(323) 400-6522
Entity
Organization
Contact information
Practice address
5949 STATE ST, HUNTINGTON PARK, CA 90255-3139
(323) 400-6595
Mailing address
5949 STATE ST, HUNTINGTON PARK, CA 90255-3139
(323) 400-6595
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
05/19/2023
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