KIDNEY DIALYSIS CENTER OF SAN LUIS OBISPO,LLC (NPI# 1033151816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033151816 |
| Entity Type | Organization |
| Organization Name | KIDNEY DIALYSIS CENTER OF SAN LUIS OBISPO,LLC |
| Practice Address |
1043 Marsh St San Luis Obispo CA 93401-3629 |
| Mailing Address |
Po Box 940838 Simi Valley CA 93094-0838 |
| Practice Telephone | 8055431013 |
| Practice Fax Number | 8055435654 |
| Mailing Telephone | 8054437777 |
| Mailing Fax Number | 8054337655 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2008-01-07 |
| Authorized Official Name | MRS. LISA VIRAL UPPONI (DIRECTOR OF ACCOUNTS RECEIVABLE) |
| Authorized Official Telephone | 8054337506 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CDC02811G | 05 | |
| CA | BLUE SHIELD | ZZZ02842Z | 01 |
| Street Address |
1043 MARSH ST |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-3629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023327467 | Total Renal Care Inc | Clinic/Center | 1043 Marsh St, San Luis Obispo, CA 93401-3629 | 2010-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477961696 | Total Renal Care Inc | Clinic/Center | 35 Casa St Ste 110, San Luis Obispo, CA 93405-1887 | 2014-07-31 |
| 1023327467 | Total Renal Care Inc | Clinic/Center | 1043 Marsh St, San Luis Obispo, CA 93401-3629 | 2010-10-04 |
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| 1669080107 | Total Renal Care Inc | Clinic/Center | 4270 Rosewood Dr Ste E, Pleasanton, CA 94588-3065 | 2020-07-21 |
| 1659997112 | Arbela Dialysis LLC | Clinic/Center | 900 Huntington Dr Ste B, San Marino, CA 91108-1825 | 2020-06-22 |
| 1275158487 | Cudahy Peritoneal Dialysis Center | Clinic/Center | 4566 Florence Ave Ste 3, Cudahy, CA 90201-4346 | 2020-06-12 |
| 1659994903 | Bio Medical Applications of California Inc | Clinic/Center | 1287 N Hacienda Blvd, La Puente, CA 91744-1631 | 2020-05-21 |
| 1245853654 | Culbert Dialysis LLC | Clinic/Center | 4223 E Anaheim St, Long Beach, CA 90804-4202 | 2020-05-20 |
| 1790308179 | Palo Dialysis LLC | Clinic/Center | 10211 Long Beach Road, Lynwood, CA 90262-1508 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
Please comment or provide details below to improve the information on KIDNEY DIALYSIS CENTER OF SAN LUIS OBISPO,LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.