Organization
RENAL TREATMENT CENTERS CALIFORNIA INC
Active
Other names
Citrus Valley 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
894 HARDT ST, SAN BERNARDINO, CA 92408-2854
(909) 388-6608
(909) 388-6639
Mailing address
5200 VIRGINIA WAY, L&C, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550000010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043271489
—
CA
Enumeration date
03/28/2006
Last updated
05/08/2024
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