Organization
EAST PALMDALE DIALYSIS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN H FISHER M.D. (OWNER/CEO)
(661) 456-1500
Entity
Organization
Contact information
Practice address
2710 E PALMDALE BLVD, PALMDALE, CA 93550-4946
(661) 456-1500
(661) 265-7089
Mailing address
2710 E PALMDALE BLVD, PALMDALE, CA 93550-4946
(661) 456-1500
(661) 265-7089
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
A41776
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC02867F
—
CA
Enumeration date
07/21/2006
Last updated
08/22/2020
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