Organization
SAN BERNARDINO VALLEY HOME DIALYSIS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLAN G KAVALICH M.D. (CEO - MEDICAL DIRECTOR)
(909) 381-1595
Entity
Organization
Contact information
Practice address
1500 N WATERMAN AVE, SUITE B, SAN BERNARDINO, CA 92404-5111
(909) 381-1595
(909) 381-3291
Mailing address
1500 N WATERMAN AVE, SUITE B, SAN BERNARDINO, CA 92404-5111
(909) 381-1595
(909) 381-3291
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2006
Last updated
05/15/2012
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