Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Upland Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
600 N 13TH AVE, UPLAND, CA 91786-4957
(909) 946-3802
(909) 946-0515
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629043583
—
CA
Enumeration date
02/22/2006
Last updated
02/26/2026
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