Organization
LONG BEACH DIALYSIS CENTER LLC
Active
Other names
Bixby Knolls Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3744 LONG BEACH BLVD, LONG BEACH, CA 90807-3310
(562) 424-1403
(562) 424-4310
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550000754
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003024647
—
CA
Enumeration date
05/18/2007
Last updated
01/21/2025
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