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Organization

NORTHRIDGE DIALYSIS CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VINOD M ASSOMULL M.D. (OWNER)
(818) 321-5800
Entity
Organization

Contact information

Practice address
9325 RESEDA BLVD, NORTHRIDGE, CA 91324-2983
(818) 993-6700
(818) 993-6711
Mailing address
4000 COVER ST, STE 100, LONG BEACH, CA 90808-1790
(562) 421-2690
(562) 421-2060

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550001462
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801128301
CA
Enumeration date
02/08/2010
Last updated
11/29/2016
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