Organization
GLENDALE NEPHROLOGY SERVICES, LLC
Active
Organization
GLENDALE NEPHROLOGY SERVICES, LLC
Active
Other names
GLENDALE KIDNEY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
RAFFI MINASIAN MD (OWNER)
(818) 662-0222
Entity
Organization
Contact information
Practice address
1427 S GLENDALE AVE, GLENDALE, CA 91205-3313
(818) 662-0222
Mailing address
1427 S GLENDALE AVE, GLENDALE, CA 91205-3313
(818) 662-0222
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
930000942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC02859F
—
CA
Enumeration date
09/28/2006
Last updated
10/11/2012
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