Unknown Individual – Nephrology Physician, NPI 1174545693

Unknown Individual is a healthcare provider. based in Northridge, California. specializing in Nephrology Physician. They hold a License No. A25072 (CA). The NPI Number for Unknown Individual is 1174545693

Main info

Organization
Inactive
59 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174545693
Phone
(818) 886-7300
Address
8349 RESEDA BLVD
Deactivation Date
8 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8188867300
Graduation Year
1967 (59 years ago)
PAC ID
6709817059
Group Practice PAC ID
3274693270
Professional Enrollment ID
I20100708000804
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 8349, Reseda Boulevard, Northridge, Los Angeles, Los Angeles County, California, 91324, United States

    SUITE G

    NORTHRIDGE, CA 913244622

    Phone: (818) 886-7300

    Fax: (818) 886-8786

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $65.

Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.

Last reported payment date: 2024-11-04 • Largest payer in this snapshot: AKEBIA THERAPEUTICS INC ($26).

Total Amount

$65

General + Research + Ownership

Payments

3

Total payment records

General Amount

$65

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90960Dialysis services, 4 or more physician visits per month (20 years or older)21225$0
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Insurance plans in this area (ZIP 91324)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1174545693 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Nephrology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Northridge?
Public fields place Unknown Individual around Northridge, California. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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