Organization
DAVITA RIVERSIDE II LLC
Active
Other names
Eastvale Preserve Dialysis, Norco Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
14260 SCHLEISMAN RD, EASTVALE, CA 92880-4020
(951) 625-3065
(951) 625-3090
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
550000399
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030400051968200000
TRICARE
—
05
—
1033159264
—
CA
Enumeration date
06/07/2006
Last updated
11/11/2025
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