Organization
TOTAL RENAL CARE INC
Active
Other names
Montclair Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
9140 MONTE VISTA AVE, MONTCLAIR, CA 91763-1723
(909) 626-6505
(909) 624-5736
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000695
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992768329
—
CA
Enumeration date
04/07/2006
Last updated
02/27/2025
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