Organization
KIDNEY DIALYSIS CENTER OF PISMO BEACH, LLC
Active
Organization
KIDNEY DIALYSIS CENTER OF PISMO BEACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA VIRAL UPPONI (DIRECTOR OF ACCOUNTS RECEIVABLE)
(805) 433-7506
Entity
Organization
Contact information
Practice address
320 JAMES WAY, SUITE # 110, PISMO BEACH, CA 93449-2813
(805) 556-0577
(805) 433-7655
Mailing address
PO BOX 940838, SIMI VALLEY, CA 93094-0838
(805) 433-7777
(805) 433-7655
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC52556
—
CA
Enumeration date
06/19/2006
Last updated
07/30/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up