Organization
DOLORES DIALYSIS LLC
Active
Other names
Cathedral City 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
30885 DATE PALM DR, CATHEDRAL CITY, CA 92234-2958
(760) 202-3491
(760) 202-7015
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
5500001638
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033429287
—
CA
Enumeration date
10/20/2010
Last updated
11/04/2024
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