Healthcare Provider Details

I. General information

NPI: 1952914681
Provider Name (Legal Business Name): WEST COAST KIDNEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 08/24/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 EAST ST STE 305
CONCORD CA
94520-2066
US

IV. Provider business mailing address

2222 EAST ST STE 305
CONCORD CA
94520-2066
US

V. Phone/Fax

Practice location:
  • Phone: 925-686-1230
  • Fax:
Mailing address:
  • Phone: 925-686-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROHIT SHARMA
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 925-686-1230