Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Chino Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAM T WEY AO (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4445 RIVERSIDE DR, CHINO, CA 91710-3961
(909) 464-0347
(909) 464-0936
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
240000523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679547087
—
CA
Enumeration date
02/14/2006
Last updated
12/07/2023
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