BOHAMA DIALYSIS LLC NPI 1497095905

NPI Information

  • NPI: 1497095905
  • Provider Name: BOHAMA DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: RANCHO CUCAMONGA HOME TRAINING
  • CLIA Number: 05D2065427
  • Address: 8219 ROCHESTER AVE
    STE 120
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Phone: (909) 466-5489

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NPI Details

BOHAMA DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Rancho Cucamonga, CA. BOHAMA DIALYSIS LLC NPI is 1497095905. The provider is registered as an organization entity type.
The provider Is Doing Business As Rancho Cucamonga Home Training.

The provider's business location address is:

8219 ROCHESTER AVE
STE 120
RANCHO CUCAMONGA, CA
ZIP 91730-723
Phone: (909) 466-5489
Fax: (909) 477-2098

The provider's authorized official is Samuel Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 05D2065427 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2013 and was last updated on 3/29/2024.

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) TreatmentYes

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
11497095905MEDICAIDCALIFORNIA

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: 11/21/2025

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