Organization
WEST COAST RENAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIESHI YAN M.D. (PRESIDENT)
(818) 718-2301
Entity
Organization
Contact information
Practice address
2925 SYCAMORE DR, SUITE 160, SIMI VALLEY, CA 93065-1207
(805) 584-0177
(805) 584-1179
Mailing address
13990 BEAR FENCE CT, MOORPARK, CA 93021-5022
(818) 718-2301
(818) 718-2311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
12/19/2017
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