BALBOA NEPHROLOGY MED GRP INC
NPI 1750569489
Internal Medicine - Nephrology in El Centro, CA

Active since February 05, 2008CLIA 05D0707199 · Waiver
2205 ROSS AVE, SUITE 101, EL CENTRO, CA 92243(760) 353-0404(760) 353-0392 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 16, 2026, Feb 8, 2021 (2 updates tracked since 2021).

About Balboa Nephrology Med Grp Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BALBOA NEPHROLOGY MED GRP INC (NPI 1750569489) is a healthcare organization registered as a nephrology in El Centro, California and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through December 22, 2027 and lists Stephanie Wenceslao, Contracts & Credentialing, as its authorized official.

NPPES Registry Identity

NPI1750569489
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameBALBOA NEPHROLOGY MED GRP INC
Location Address2205 ROSS AVE, SUITE 101El Centro, CA 92243-3623
Mailing Address9373 Hazard Way Ste 200San Diego, CA 92123-1226 · (858) 810-8000 · Fax (858) 268-1911
Fax(760) 353-0392
Organization SubpartNo
Authorized OfficialStephanie WenceslaoContracts & Credentialing · (858) 810-8000
Enumeration DateFebruary 5, 2008
Last NPPES UpdateJanuary 16, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2026
NPI 1750569489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
2205 ROSS AVE, El Centro, CA 92243

Other Identifiers 1

MedicaidGR0103520CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0707199

Balboa Nephrology Medical Group, Inc · El Centro, CA
Active · expires Dec 22, 2027
CLIA Number05D0707199
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorDr. Ramin Berenji
Laboratory Phone(760) 353-0404
Laboratory LocationBalboa Nephrology Medical Group, Inc2205 W Ross Ave Ste 101, El Centro, CA 92243
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Nephrology)
2205 ROSS AVE, STE 101
EL CENTRO, CA 92243
Internal Medicine (Nephrology)
2205 ROSS AVE, STE 101
EL CENTRO, CA 92243
Nurse Practitioner
2205 ROSS AVE, SUITE 101
EL CENTRO, CA 92243

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Balboa Nephrology Med Grp Inc's NPI number?

The NPI number for Balboa Nephrology Med Grp Inc is 1750569489. It was assigned to this organization in the NPPES registry on February 5, 2008.

Where is Balboa Nephrology Med Grp Inc located?

Balboa Nephrology Med Grp Inc is located at 2205 Ross Ave Suite 101, El Centro, CA 92243. The listed phone number is (760) 353-0404.

What is Balboa Nephrology Med Grp Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Balboa Nephrology Med Grp Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0707199) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Balboa Nephrology Med Grp Inc was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.