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COBBLES DIALYSIS LLC NPI 1346674157


NPI Information

NPI: 1346674157
Provider Name: COBBLES DIALYSIS LLC

Doing Business As: CHANNEL ISLANDS DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D2075611

Address:
3541 W 5TH ST STE A
OXNARD, CA
ZIP 93030
Phone: (805) 984-5140
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COBBLES DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Oxnard, CA. COBBLES DIALYSIS LLC NPI is 1346674157. The provider is registered as an organization entity type.
The provider Is Doing Business As Channel Islands Dialysis.

The provider's business location address is:

3541 W 5TH ST STE A
OXNARD, CA
ZIP 93030-403
Phone: (805) 984-5140
Fax: (805) 984-5647

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 05D2075611 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/28/2013 and was last updated on 2/8/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment550002656CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11346674157MEDICAIDCALIFORNIA

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: 11/14/2023

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