SATELLITE HEALTHCARE OF NORTH SAN MATEO COUNTY LLC NPI 1649542192

NPI Information

NPI: 1649542192
Provider Name: SATELLITE HEALTHCARE OF NORTH SAN MATEO COUNTY, LLC

Doing Business As: SATELLITE HEALTHCARE DALY CITY

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D2068495

Address:
2001 JUNIPERO SERRA BLVD
SUITE 100
DALY CITY, CA
ZIP 94014
Phone: (650) 746-3140
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SATELLITE HEALTHCARE OF NORTH SAN MATEO COUNTY, LLC is an end-stage renal disease (esrd) treatment clinic center in Daly City, CA. SATELLITE HEALTHCARE OF NORTH SAN MATEO COUNTY, LLC NPI is 1649542192. The provider is registered as an organization entity type.
The provider Is Doing Business As Satellite Healthcare Daly City.

The provider's business location address is:

2001 JUNIPERO SERRA BLVD
SUITE 100
DALY CITY, CA
ZIP 94014-891
Phone: (650) 746-3140
Fax: (650) 991-2840

The provider's authorized official is Bernadette Vincent .
The authorized official title is President/coo and has the following contact phone number (650) 404-3600.

The CLIA number assigned to this NPI record is 05D2068495 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2012 and was last updated on 2/2/2023.

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			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	1649542192	MEDICAID	CALIFORNIA
2	550002288	OTHER	CALIFORNIA	STATE OF 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

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