Provider Demographics
NPI:1902846231
Name:DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC
Entity Type:Organization
Organization Name:DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC
Other - Org Name:NORTH TEXAS KIDNEY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT SECRETARY & TREASUR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:EFTHIM
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-310-4872
Mailing Address - Street 1:PO BOX 2355
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401
Mailing Address - Country:US
Mailing Address - Phone:800-310-4872
Mailing Address - Fax:877-328-4823
Practice Address - Street 1:1323 EAST FRANKLIN STREET
Practice Address - Street 2:HILL REGIONAL MEDICAL OFFICE BUILDING
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76648
Practice Address - Country:US
Practice Address - Phone:866-419-6852
Practice Address - Fax:866-399-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty