KAMIAH DIALYSIS LLC NPI 1043631427

NPI Information

  • NPI: 1043631427
  • Provider Name: KAMIAH DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: POMONA VALLEY DIALYSIS
  • CLIA Number: 05D2077465
  • Address: 2703 S TOWNE AVE
    POMONA, CA
    ZIP 91766
  • Phone: (909) 590-4930

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NPI Details

KAMIAH DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Pomona, CA. KAMIAH DIALYSIS LLC NPI is 1043631427. The provider is registered as an organization entity type.
The provider Is Doing Business As Pomona Valley Dialysis.

The provider's business location address is:

2703 S TOWNE AVE
POMONA, CA
ZIP 91766-206
Phone: (909) 590-4930
Fax: (909) 591-8425

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 05D2077465 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2014 and was last updated on 3/17/2022.

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) Treatment550002734CALIFORNIAYes

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
11043631427MEDICAIDCALIFORNIA

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: 3/30/2025

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