DVA HEALTHCARE RENAL CARE INC NPI 1134193006

NPI Information

NPI: 1134193006
Provider Name: DVA HEALTHCARE RENAL CARE INC

Doing Business As: LOS BANOS DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
60 W G ST BLDG 5
STE D
LOS BANOS, CA
ZIP 93635
Phone: (209) 826-2787
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DVA HEALTHCARE RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Los Banos, CA. DVA HEALTHCARE RENAL CARE INC NPI is 1134193006. The provider is registered as an organization entity type.
The provider Is Doing Business As Los Banos Dialysis.

The provider's business location address is:

60 W G ST BLDG 5
STE D
LOS BANOS, CA
ZIP 93635-658
Phone: (209) 826-2787
Fax: (209) 826-6325

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp, Licensure & Certification and has the following contact phone number (615) 341-6641.

The enumeration date for this NPI number is 2/15/2006 and was last updated on 3/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	240000794	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1134193006	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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