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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