Organization
TUSTIN DIALYSIS CENTER LLC
Active
Other names
Tustin 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
2090 N TUSTIN AVE STE 100, SANTA ANA, CA 92705-7869
(714) 835-2450
(714) 835-5715
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
080000766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174586226
—
CA
Enumeration date
04/10/2006
Last updated
02/26/2026
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