Organization
DVA RENAL HEALTHCARE INC
Active
Other names
College 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
6535 UNIVERSITY AVE, SAN DIEGO, CA 92115-6341
(619) 287-8796
(619) 287-4862
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
080000775
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902870330
—
CA
Enumeration date
02/14/2006
Last updated
02/24/2026
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