Organization
MK DIALYSIS CENTER AT RIVERSIDE, INC.
Active
Organization
MK DIALYSIS CENTER AT RIVERSIDE, INC.
Active
Other names
Van buren Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMMED QUTUB KHAN MD (PRESIDENT/CFO)
(951) 735-1257
Entity
Organization
Contact information
Practice address
3595 VAN BUREN BLVD, SUITE 101, RIVERSIDE, CA 92503-0311
(909) 542-2900
Mailing address
3595 VAN BUREN BLVD, SUITE 101, RIVERSIDE, CA 92503-0311
(909) 542-2900
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
—
1245567627
NPI
CA
Enumeration date
11/05/2009
Last updated
07/11/2016
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