Organization
SYLMAR DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINOD M ASSOMULL M.D. (OWNER)
(818) 321-5800
Entity
Organization
Contact information
Practice address
12151 SAN FERNANDO ROAD, SYLMAR, CA 91342-5003
(818) 465-9464
(818) 367-0340
Mailing address
4000 COVER ST STE 100, LONG BEACH, CA 90808-1790
(562) 421-2690
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
—
1871903385
—
CA
Enumeration date
05/06/2014
Last updated
11/29/2016
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