Organization
KAWEAH DELTA HEALTH CARE DISTRICT
Active
Parent organization
KAWEAH DELTA HEALTH CARE DISTRICT
Other names
Kaweah Delta Porterville Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAWEAH DELTA HEALTH CARE DISTRICT
Authorized official
MALINDA TUPPER (SRVP/CHIEF FINANCIAL OFFICER)
(559) 624-4065
Entity
Organization
Contact information
Practice address
385 PEARSON DR, PORTERVILLE, CA 93257-3305
(559) 624-2000
(559) 713-2356
Mailing address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(559) 624-2739
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000785
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC02642F
—
CA
01
—
ZZZ12669Z
BLUE SHIELD
CA
Enumeration date
03/29/2006
Last updated
03/07/2023
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