Organization
SOLANO DIALYSIS ACCESS CENTER, A PROFESSIONAL CORPORATION.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA PAGTALUNAN MD (MEDICAL DIRECTOR)
(510) 841-4525
Entity
Organization
Contact information
Practice address
127 HOSPITAL DR, STE 102, VALLEJO, CA 94589-2500
(707) 643-9010
(707) 643-9011
Mailing address
127 HOSPITAL DR, STE 102, VALLEJO, CA 94589-2500
(707) 643-9010
(707) 643-9011
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0106040
MEDICAL - GROUP
CA
01
—
ZZZ06222Z
MEDICARE - GROUP
CA
Enumeration date
08/10/2007
Last updated
06/21/2018
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