TOTAL RENAL CARE INC NPI 1992768329

NPI Information

NPI: 1992768329
Provider Name: TOTAL RENAL CARE INC

Doing Business As: MONTCLAIR DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
9140 MONTE VISTA AVE
MONTCLAIR, CA
ZIP 91763
Phone: (909) 626-6505
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TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Montclair, CA. TOTAL RENAL CARE INC NPI is 1992768329. The provider is registered as an organization entity type.
The provider Is Doing Business As Montclair Dialysis Center.

The provider's business location address is:

9140 MONTE VISTA AVE
MONTCLAIR, CA
ZIP 91763-723
Phone: (909) 626-6505
Fax: (909) 624-5736

The provider's authorized official is Samuel T. 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 05D0924350 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 4/5/2024.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	240000695	CALIFORNIA	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	1992768329	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: 5/5/2024

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