Organization
CALIFORNIA KIDNEY MEDICAL GROUP INC
Active
Organization
CALIFORNIA KIDNEY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILY KRASTEIN (ADMINISTRATOR)
(805) 433-7507
Entity
Organization
Contact information
Practice address
50 MORELAND RD, SIMI VALLEY, CA 93065-1659
(805) 433-7360
(805) 306-0620
Mailing address
PO BOX 940838, SIMI VALLEY, CA 93094-0838
(805) 433-7777
(805) 433-7607
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 320950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB23131F
—
CA
Enumeration date
07/22/2006
Last updated
02/26/2009
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