MEDICARE: DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1093755324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC

Provider Business Mailing Address
First Line	:	PO BOX FILE57025
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90074-0001
Country	:	US
Telephone Number	:	303-626-6239
Fax Number	:	866-917-5396

Provider Business Practice Location Address
First Line	:	3515 SWISS AVE FL B2
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6223
Country	:	US
Telephone Number	:	303-626-6239
Fax Number	:	866-917-5396

Authorized Official
Title or Position	:	OWNER PRESIDENT SECRETARY & TREASUR
Name	:	DR. ANTHONY EFTHIM GABRIEL
Credential	:	MD
Telephone Number	:	800-310-4872

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	05/04/2009

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