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USC DAVITA DIALYSIS CENTER LLC NPI 1376118281


NPI Information

NPI: 1376118281
Provider Name: USC DAVITA DIALYSIS CENTER LLC

Doing Business As: USC KOREA TOWN HOME DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D2230213

Address:
3660 WILSHIRE BLVD STE 338
LOS ANGELES, CA
ZIP 90010
Phone: (213) 900-1416
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USC DAVITA DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Los Angeles, CA. USC DAVITA DIALYSIS CENTER LLC NPI is 1376118281. The provider is registered as an organization entity type.
The provider Is Doing Business As Usc Korea Town Home Dialysis.

The provider's business location address is:

3660 WILSHIRE BLVD STE 338
LOS ANGELES, CA
ZIP 90010-752
Phone: (213) 900-1416
Fax: (213) 900-1438

The provider's authorized official is John D. Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 05D2230213 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2021 and was last updated on 9/26/2022.


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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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

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