Organization
RAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
RAI-Garden Grove-Garden Grove
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
MR. MARK R FAWCETT (TREASURER)
(781) 699-9000
Entity
Organization
Contact information
Practice address
12555 GARDEN GROVE BLVD, SUITE 100, GARDEN GROVE, CA 92843-1902
(714) 741-7255
(714) 741-2029
Mailing address
12555 GARDEN GROVE BLVD, SUITE100, GARDEN GROVE, CA 92843-1902
(714) 741-7255
(714) 741-2029
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052617
BLUE CROSS OF CALIFORNIA
CA
05
—
CDC02617G
—
CA
01
—
ZZZR0209Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
11/17/2006
Last updated
07/27/2012
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