Provider Demographics
NPI:1629016373
Name:NMA MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NMA MEDICAL CORPORATION
Other - Org Name:NEPHROLOGY MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-705-7212
Mailing Address - Street 1:5525 ETIWANDA AVE
Mailing Address - Street 2:305
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3647
Mailing Address - Country:US
Mailing Address - Phone:818-705-7212
Mailing Address - Fax:818-705-7215
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:305
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3647
Practice Address - Country:US
Practice Address - Phone:818-705-7212
Practice Address - Fax:818-705-7215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0079020Medicaid
CAW13406Medicare ID - Type UnspecifiedGROUP PROVIDER NUMER