Organization
TOTAL RENAL CARE INC
Active
Other names
Iowa Street 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
8333 IOWA ST, STE 100, DOWNEY, CA 90241-4994
(562) 923-5901
(562) 923-6000
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
550000983
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962754333
—
CA
Enumeration date
10/10/2012
Last updated
06/10/2024
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