TRICITY RIVERSIDE DIALYSIS NPI 1003396615

NPI Information

NPI: 1003396615
Provider Name: TRICITY RIVERSIDE DIALYSIS
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D2167318

Address:
7275 INDIANA AVE
RIVERSIDE, CA
ZIP 92504
Phone: (951) 343-1978
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TRICITY RIVERSIDE DIALYSIS is an end-stage renal disease (esrd) treatment clinic center in Riverside, CA. TRICITY RIVERSIDE DIALYSIS NPI is 1003396615. The provider is registered as an organization entity type.

The provider's business location address is:

7275 INDIANA AVE
RIVERSIDE, CA
ZIP 92504-543
Phone: (951) 343-1978

The provider's authorized official is Mohammed Qutub Khan .
The authorized official title is President and has the following contact phone number (951) 343-1978.

The CLIA number assigned to this NPI record is 05D2167318 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2018 and was last updated on 3/25/2019.

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

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: 4/28/2024

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