# CAMINO RENAL CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871161885
- **Authorized official:** GLENN DAVIS (PRESIDENT)
- **Authorized official phone:** (949) 246-8581

## Contact information

- **Practice address:** 4225 EXECUTIVE SQ STE 450, LA JOLLA, CA 92037-8411
- **Practice address phone:** (858) 810-8000
- **Mailing address:** 4225 EXECUTIVE SQ STE 450, LA JOLLA, CA 92037-8411
- **Mailing address phone:** (858) 810-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2021
- **Last updated:** 06/15/2021