Organization
BRADDOCK DIALYSIS LLC
Active
Other names
Westmont Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
11239 S WESTERN AVE, LOS ANGELES, CA 90047-4848
(323) 242-3970
(323) 777-2163
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
04/03/2018
Last updated
08/13/2025
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