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PACIFIC NEPHROLOGY MEDICAL GROUP
NPI 1922013515
Internal Medicine - Nephrology in Inglewood, CA

Active since July 30, 2006CLIA 05D0705927 · Waiver
323 N PRAIRIE AVE # 334, INGLEWOOD, CA 90301(310) 674-8600(310) 671-9883 Get Directions Write a Review

NPPES record last updated: September 21, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pacific Nephrology Medical Group NPPES

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

PACIFIC NEPHROLOGY MEDICAL GROUP (NPI 1922013515) is a healthcare organization registered as a nephrology in Inglewood, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Michael Dylan Healy, Partner, as its authorized official.

NPPES Registry Identity

NPI1922013515
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NamePACIFIC NEPHROLOGY MEDICAL GROUP
Location Address323 N PRAIRIE AVE # 334Inglewood, CA 90301-4502
Mailing Address323 N Prairie Ave # 334Inglewood, CA 90301-4502 · (310) 674-8600 · Fax (310) 671-9883
Phone(310) 674-8600
Fax(310) 671-9883
Organization SubpartNo
Authorized OfficialMichael Dylan HealyPartner · (310) 674-8600
Enumeration DateJuly 30, 2006
Last NPPES UpdateSeptember 21, 2009
✔ NPI 1922013515 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.
323 N PRAIRIE AVE # 334, Inglewood, CA 90301
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Other Identifiers 2

Medicare ID-Type UnspecifiedW5961ACA
MedicaidGR0000360CA

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 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 05D0705927

Pacific Nephrology Medical Group · Inglewood, CA
Active · expires Aug 31, 2026
CLIA Number05D0705927
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRichard L. Sires
Laboratory Phone(310) 674-8600
Laboratory LocationPacific Nephrology Medical Group323 N Prairie Ave #334, Inglewood, CA 90301
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

YEP H. WONG, M.D. INC
Specialist
323 N PRAIRIE AVE # 334
INGLEWOOD, CA 90301
Los Angeles County (310) 680-9300

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 Pacific Nephrology Medical Group's NPI number?

The NPI number for Pacific Nephrology Medical Group is 1922013515. It was assigned to this organization in the NPPES registry on July 30, 2006.

Where is Pacific Nephrology Medical Group located?

Pacific Nephrology Medical Group is located at 323 N Prairie Ave # 334, Inglewood, CA 90301. The listed phone number is (310) 674-8600.

What is Pacific Nephrology Medical Group's specialty?

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

Does Pacific Nephrology Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0705927) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pacific Nephrology Medical Group was last updated on September 21, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.