Provider Demographics
NPI:1700827516
Name:THE NEPHROLOGY GROUP, INC.
Entity Type:Organization
Organization Name:THE NEPHROLOGY GROUP, INC.
Other - Org Name:CENTRAL VALLEY NEPHROLOGY MEDICAL ASSOCIATES INCORPORATED
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NEPHROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ATULKUMAR
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-725-2121
Mailing Address - Street 1:1140 OLIVEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-1210
Mailing Address - Country:US
Mailing Address - Phone:209-725-2121
Mailing Address - Fax:209-725-2123
Practice Address - Street 1:1140 OLIVEWOOD DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1210
Practice Address - Country:US
Practice Address - Phone:209-725-2121
Practice Address - Fax:209-725-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RN0300X
CA207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0082110Medicaid
CAZZZ14310ZMedicare ID - Type Unspecified