Organization
MORENO VALLEY REGIONAL DIALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GADSALLI RAMASWAMY RAVIKUMAR M.D (PRESIDENT/CEO)
(714) 226-0818
Entity
Organization
Contact information
Practice address
22620 GOLDENCREST DRIVE, SUITE 101, MORENO VALLEY, CA 92553-9032
(951) 656-3804
(951) 656-7508
Mailing address
3356 W BALL RD, ANAHEIM, CA 92804-3702
(714) 226-0818
(714) 226-0700
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000808
CA
Other
Enumeration date
09/04/2007
Last updated
11/27/2012
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