OrganizationActive
California Kidney Medical Group Inc
NPI 1659537835 · Vascular Surgery Physician · Northridge, CA
Provider details
- NPI number
- 1659537835
- Entity type
- Organization
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lily Krastein, Administrator(805) 433-7507
- License
- G83840 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
18546 Roscoe Blvd
Suite 120
Northridge, CA 91324-4663
Phone: (818) 886-3773
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 940838
Simi Valley, CA 93094-0838
Registry dates
- Enumerated
- 2008-08-06
- Last updated
- 2008-08-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.