CORAL DIALYSIS LLC NPI 1437569514

NPI Information

CORAL DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Stockton, CA. CORAL DIALYSIS LLC NPI is 1437569514. The provider is registered as an organization entity type.
The provider Is Doing Business As Port City Dialysis.

The provider's business location address is:

1810 S FRESNO AVE
STOCKTON, CA
ZIP 95206-861
Phone: (209) 946-0738
Fax: (209) 946-0827

The provider's authorized official is John 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 05D2086215 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/29/2014 and was last updated on 4/10/2023.

Taxonomy Codes

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