Organization
PERITONEAL DIALYSIS CENTER OF AMERICA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADIP CP CHOWDHURY MD (VICE PRESIDENT)
(323) 371-4182
Entity
Organization
Contact information
Practice address
3112 W BEVERLY BLVD, MONTEBELLO, CA 90640-2217
(323) 722-2053
(323) 722-2063
Mailing address
3112 W BEVERLY BLVD, MONTEBELLO, CA 90640-2217
(323) 722-2053
(323) 722-2063
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A79279
KAVITHA KANAKARAJ, MD
CA
Enumeration date
08/18/2006
Last updated
06/10/2025
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