Healthcare Provider Details

I. General information

NPI: 1053499582
Provider Name (Legal Business Name): DONALD W. INADOMI, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20911 EARL ST SUITE 320
TORRANCE CA
90503-4352
US

IV. Provider business mailing address

20911 EARL ST SUITE 320
TORRANCE CA
90503-4352
US

V. Phone/Fax

Practice location:
  • Phone: 310-542-7997
  • Fax: 310-542-2607
Mailing address:
  • Phone: 310-542-7997
  • Fax: 310-542-2607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberG42789
License Number StateCA

VIII. Authorized Official

Name: DR. DONALD WARREN INADOMI
Title or Position: PRESIDENT
Credential: MD
Phone: 310-542-7997