Organization
HOME DIALYSIS CENTERS OF RANCHO CUCAMONGA LLC
Active
Other names
Home Dialysis Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN MEHRABIAN MSC (DIRECTOR OF OPERATIONS)
(818) 939-2047
Entity
Organization
Contact information
Practice address
8239 ROCHESTER AVE, SUITE 110, RANCHO CUCAMONGA, CA 91730-0714
(909) 945-2104
(909) 945-2152
Mailing address
8239 ROCHESTER AVE, SUITE 110, RANCHO CUCAMONGA, CA 91730-0714
(909) 945-2104
(909) 945-2152
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
—
1720314982
—
CA
Enumeration date
10/23/2009
Last updated
04/08/2022
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