Organization
TOTAL RENAL CARE INC
Active
Organization
TOTAL RENAL CARE INC
Active
Parent organization
DAVITA INC
Other names
Avalon Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
5807 AVALON BLVD, LOS ANGELES, CA 90011-5303
(323) 233-2452
(323) 233-2549
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
550003039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659780120
—
CA
Enumeration date
08/08/2014
Last updated
01/05/2023
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