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Organization

SANTA FE SPRINGS REGIONAL DIALYSIS CENTER LLC

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
10012 NORWALK BLVD, SUITE 190, SANTA FE SPRINGS, CA 90670-3343
(562) 903-8281
(562) 903-8289
Mailing address
3356 W BALL RD, ANAHEIM, CA 92804-3702
(714) 226-0618
(714) 226-0700

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
930000659
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CDC02724G
CA
Enumeration date
05/27/2006
Last updated
11/27/2012
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