Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Daly City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1498 SOUTHGATE AVE, STE 101, DALY CITY, CA 94015-4015
(650) 755-4751
(650) 755-0356
Mailing address
5200 VIRGINIA WAY, L&C DEPT 4TH FL, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
140000620
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881668234
—
CA
Enumeration date
02/14/2006
Last updated
02/12/2024
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