Organization
RENAL TREATMENT CENTERS CALIFORNIA INC
Active
Other names
Lakeport Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
244 PECKHAM CT, LAKEPORT, CA 95453-9203
(707) 262-1349
(707) 262-1355
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110000436
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609835438
—
CA
Enumeration date
03/21/2006
Last updated
02/14/2024
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