Organization
RAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
RAI-Harbor Blvd.-Garden Grove
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
MARK R. FAWCETT (TREASURER)
(781) 699-9000
Entity
Organization
Contact information
Practice address
12761 HARBOR BLVD, GARDEN GROVE, CA 92840-5800
(714) 539-3122
(714) 539-3922
Mailing address
12761 HARBOR BLVD., GARDEN GROVE, CA 92840-5800
(714) 539-3122
(714) 539-3922
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
01
—
552527
BLUE CROSS OF CALIFORNIA
CA
05
—
CDC52527G
—
CA
01
—
ZZZR0210Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
11/17/2006
Last updated
01/27/2016
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