Organization
GREATER LOS ANGELES DIALYSIS CENTERS LLC
Active
Other names
University Park Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3986 S FIGUEROA ST, LOS ANGELES, CA 90037-1222
(213) 749-8297
(213) 749-0472
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
930000461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003879081
—
CA
Enumeration date
04/10/2006
Last updated
06/07/2024
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