Organization
WALCOTT DIALYSIS LLC
Active
Other names
Newport Irvine 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
4300 VON KARMAN AVE, NEWPORT BEACH, CA 92660-2004
(949) 863-1382
(949) 863-1407
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550003126
CA
Other
Enumeration date
01/06/2014
Last updated
04/24/2024
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