Organization
NEPHRON DIALYSIS CENTER OF LAKEWOOD LLC
Active
Organization
NEPHRON DIALYSIS CENTER OF LAKEWOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GADSALLI RAMASWAMY RAVIKUMAR M.D (PRESIDENT/CEO)
(714) 226-0818
Entity
Organization
Contact information
Practice address
5820 DOWNEY AVENUE, LONG BEACH, CA 90805-4517
(562) 663-0788
(562) 663-0794
Mailing address
3356 W. BALL ROAD, SUITE 216, ANAHEIM, CA 92804-3702
(714) 226-0818
(714) 226-0700
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
930000886
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC02788G
—
CA
Enumeration date
07/18/2006
Last updated
11/27/2012
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