Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Saddleback 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
23141 PLAZA POINTE DR, LAGUNA HILLS, CA 92653-1425
(949) 588-9211
(949) 588-9299
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
080000693
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962476606
—
CA
Enumeration date
02/16/2006
Last updated
02/25/2026
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