SATELLITE HEALTHCARE OF NORTH TRACY LLC NPI 1669069118

NPI Information

NPI: 1669069118
Provider Name: SATELLITE HEALTHCARE OF NORTH TRACY, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D2241873

Address:
1005 N PESCADERO AVENUE
SUITE 201-207
TRACY, CA
ZIP 95304
Phone: (669) 236-5947
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SATELLITE HEALTHCARE OF NORTH TRACY, LLC is an end-stage renal disease (esrd) treatment clinic center in Tracy, CA. SATELLITE HEALTHCARE OF NORTH TRACY, LLC NPI is 1669069118. The provider is registered as an organization entity type.

The provider's business location address is:

1005 N PESCADERO AVENUE
SUITE 201-207
TRACY, CA
ZIP 95304-507
Phone: (669) 236-5947
Fax: (650) 625-6007

The provider's authorized official is Bernadette L Vincent .
The authorized official title is Coo/president and has the following contact phone number (650) 404-3600.

The CLIA number assigned to this NPI record is 05D2241873 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/30/2020 and was last updated on 1/23/2023.

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

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: 5/5/2024

NPI Synchronization or Removal

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