San Pablo Dialysis

LBN: Dva Healthcare Renal Care Inc
San Pablo Dialysis is an health care organization with primary practice located at 14020 San Pablo Ave , San Pablo CA 94806-3604. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Dva Healthcare Renal Care Inc can be contacted via phone (510) 234-0835, or through Usilton, Thomas O via phone (770) 541-7922.

Contact Information

Primary practice address
14020 San Pablo Ave San Pablo CA 94806-3604
Phone: (510) 234-0835
Fax: (510) 234-3854
Website:
Map and Directions
Authorized official contact:
Name: Usilton, Thomas O
Phone: (770) 541-7922

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X California

Profile Details

NPI number 1942275953
LBN Legal business name Dva Healthcare Renal Care Inc
DBA Doing business as San Pablo Dialysis
Authorized official Usilton, Thomas O
Entity Organization
Organization subpart 1 No
Enumeration date Feb 22nd, 2006
Last updated Aug 14th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942275953 NPPES
California MEDICAID CDC02560G

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