Provider Demographics
NPI:1497373237
Name:MVP NEPHROLOGY DIALYSIS PC
Entity Type:Organization
Organization Name:MVP NEPHROLOGY DIALYSIS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RABBANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-259-4724
Mailing Address - Street 1:501 W GLENOAKS BLVD STE 341
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2896
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4911 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1716
Practice Address - Country:US
Practice Address - Phone:818-981-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty