Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
512 CYPRESS ST, FORT BRAGG, CA 95437-5410
(707) 964-1610
(707) 964-1609
Mailing address
180 NORTHPOINT DR, REDDING, CA 96003-2510
(530) 246-1140
(530) 246-1128
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC52566F
—
CA
Enumeration date
07/22/2006
Last updated
10/05/2023
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