DVA HEALTHCARE RENAL CARE INC NPI 1053386912

NPI Information

  • NPI: 1053386912
  • Provider Name: DVA HEALTHCARE RENAL CARE INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: VALLEJO DIALYSIS
  • Address: 121 HOSPITAL DR
    VALLEJO, CA
    ZIP 94589
  • Phone: (707) 553-9174

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NPI Details

DVA HEALTHCARE RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Vallejo, CA. DVA HEALTHCARE RENAL CARE INC NPI is 1053386912. The provider is registered as an organization entity type.
The provider Is Doing Business As Vallejo Dialysis.

The provider's business location address is:

121 HOSPITAL DR
VALLEJO, CA
ZIP 94589-562
Phone: (707) 553-9174
Fax: (707) 553-9678

The provider's authorized official is Thomas O Usilton .
The authorized official title is Group Vice President and has the following contact phone number (770) 541-7922.

The enumeration date for this NPI number is 2/22/2006 and was last updated on 8/14/2007.

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) TreatmentCALIFORNIAYes

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
1052567MEDICARE OSCAR/CERTIFICATION
2CDC70011FMEDICAIDCALIFORNIA

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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