RAI CARE CENTERS OF SOUTHERN CALIFORNIA II LLC NPI 1114091840

NPI Information

NPI: 1114091840
Provider Name: RAI CARE CENTERS OF SOUTHERN CALIFORNIA II, LLC

Doing Business As: RAI - MISSION GORGE - SAN DIEGO

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D0919976

Address:
7007 MISSION GORGE RD
SAN DIEGO, CA
ZIP 92120
Phone: (619) 229-1070
Get Directions

RAI CARE CENTERS OF SOUTHERN CALIFORNIA II, LLC is an end-stage renal disease (esrd) treatment clinic center in San Diego, CA. RAI CARE CENTERS OF SOUTHERN CALIFORNIA II, LLC NPI is 1114091840. The provider is registered as an organization entity type.
The provider Is Doing Business As Rai - Mission Gorge - San Diego.

The provider's business location address is:

7007 MISSION GORGE RD
SAN DIEGO, CA
ZIP 92120-422
Phone: (619) 229-1070
Fax: (619) 265-0409

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 05D0919976 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 10/17/2023.

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	ZZZR0220Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIFORNIA
2	052779	OTHER	CALIFORNIA	BLUE CROSS OF CALIFORNIA
3	CDC02779G	MEDICAID	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: 4/28/2024

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