Organization
MOBILE DIALYSIS SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE SUAREZ (SUPERVISOR)
(562) 598-2705
Entity
Organization
Contact information
Practice address
801 W COMPTON BLVD, COMPTON, CA 90220-2924
(310) 637-9026
Mailing address
3810 KATELLA AVE, LOS ALAMITOS, CA 90720-3302
(562) 598-9399
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT11766G
—
CA
Enumeration date
08/15/2005
Last updated
08/22/2020
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