Organization
ONTARIO DIALYSIS CENTER LLC
Active
Other names
Ontario Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
1950 S GROVE AVE, STE 101, ONTARIO, CA 91761-5693
(909) 930-5566
(909) 930-5690
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550000080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC52548F
—
CA
Enumeration date
04/10/2006
Last updated
09/24/2007
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