Organization
DAVITA RIVERSIDE LLC
Active
Other names
Murrieta 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
27602 CLINTON KEITH RD BLDG F, MURRIETA, CA 92562-8513
(951) 679-7914
(951) 679-7693
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
240000806
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003879461
—
CA
Enumeration date
04/07/2006
Last updated
05/06/2026
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