Organization
LACNA DIALYSIS ACCESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS R. GONZALEZ M.D. (MEDICAL DIRECTOR)
(323) 726-3868
Entity
Organization
Contact information
Practice address
3112 W. BEVERLY BLVD., MONTEBELLO, CA 90640-2217
(323) 726-3868
Mailing address
3112 W. BEVERLY BLVD., MONTEBELLO, CA 90640-2217
(323) 726-3868
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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