| West Coast Renal Medical Group, Inc | |
|
2925 Sycamore Dr Suite 160 Simi Valley CA 93065-1207 | |
| (805) 584-0177 | |
| (805) 584-1179 |
| Full Name | West Coast Renal Medical Group, Inc |
|---|---|
| Speciality | Internal Medicine - Nephrology |
| Location | 2925 Sycamore Dr, Simi Valley, California |
| Authorized Official Name and Position | Jieshi Yan (PRESIDENT) |
| Authorized Official Contact | 8187182301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Coast Renal Medical Group, Inc 13990 Bear Fence Ct Moorpark CA 93021-5022 Ph: (818) 718-2301 | West Coast Renal Medical Group, Inc 2925 Sycamore Dr Suite 160 Simi Valley CA 93065-1207 Ph: (805) 584-0177 |
| NPI Number | 1740637875 |
|---|---|
| Provider Enumeration Date | 05/18/2016 |
| Last Update Date | 12/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740637875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
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