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Organization

CALIFORNIA KIDNEY MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LILY KRASTEIN (ADMINISTRATOR)
(805) 433-7507
Entity
Organization

Contact information

Practice address
18546 ROSCOE BLVD, SUITE 120, NORTHRIDGE, CA 91324-4663
(818) 886-3773
Mailing address
PO BOX 940838, SIMI VALLEY, CA 93094-0838
(805) 433-7507

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G83840
CA

Other

Enumeration date
08/06/2008
Last updated
08/06/2008
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