Provider Demographics
NPI:1285510420
Name:AMERICAN RENAL SERVICE
Entity type:Organization
Organization Name:AMERICAN RENAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOSOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:AFSHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:442-283-5049
Mailing Address - Street 1:220 N IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-1265
Mailing Address - Country:US
Mailing Address - Phone:442-283-5049
Mailing Address - Fax:
Practice Address - Street 1:220 N IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-1265
Practice Address - Country:US
Practice Address - Phone:442-283-5049
Practice Address - Fax:442-283-5089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN RENAL SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty