Organization
EVN DIALYSIS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GUNDA JAHROMI (PARTNER)
(818) 457-3949
Entity
Organization
Contact information
Practice address
18040 SHERMAN WAY STE 100, RESEDA, CA 91335-4656
(818) 457-3949
(818) 609-0076
Mailing address
18040 SHERMAN WAY STE 100, RESEDA, CA 91335-4656
(818) 457-3949
(818) 609-0076
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001
N/A
CA
Enumeration date
08/27/2019
Last updated
07/28/2021
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