Organization
HAWAIIAN GARDENS DIALYSIS CENTER LLC
Active
Other names
South Cerritos Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
12191 226TH ST, HAWAIIAN GARDENS, CA 90716-1510
(562) 421-4016
(562) 421-4652
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6765
(833) 782-9089
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550001463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437397536
—
CA
Enumeration date
01/27/2009
Last updated
08/04/2020
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