Organization
INDIAN WELLS VALLEY DIALYSIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM A HADAYA M.D. (OWNER)
(661) 267-7642
Entity
Organization
Contact information
Practice address
212 S RICHMOND RD, RIDGECREST, CA 93555-4434
(760) 371-7506
Mailing address
1643 E PALMDALE BLVD, PALMDALE, CA 93550-4847
(661) 267-7642
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
04/23/2009
Last updated
04/24/2009
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