DAVITA RIVERSIDE II LLC (NPI# 1033159264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033159264 |
| Entity Type | Organization |
| Organization Name | DAVITA RIVERSIDE II LLC |
| Other Organization Name | NORCO DIALYSIS |
| Practice Address |
1901 Town and Country Dr Ste 100 Norco CA 92860-3611 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9517380185 |
| Practice Fax Number | 9517388490 |
| Mailing Telephone | 6153416793 |
| Mailing Fax Number | 8777902174 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | JOHN D. WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 |
550000399 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1033159264 | 05 | |
| TRICARE | 030400051968200000 | 01 |
| Other Name | Type Code |
|---|---|
| Norco Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316971641 | Davita Riverside II LLC | Clinic/Center | 11161 Magnolia Ave, Riverside, CA 92505-3605 | 2006-07-11 |
| Street Address |
1901 TOWN AND COUNTRY DR STE 100 |
| City | NORCO |
| State | CA |
| Zip Code | 92860-3611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104466119 | Julie Chang | Pharmacist | 1101 Hidden Valley Parkway, Norco, CA 92860 | 2020-01-08 |
| 1629629241 | Abbey West Transportation LLC | Non-emergency Medical Transport (VAN) | 1791 Third St, Norco, CA 92860 | 2019-09-25 |
| 1457906745 | Corrections and Rehabilitation | Pharmacy | 5th and Western Ave, Module M, Room #104, Norco, CA 92860 | 2019-08-05 |
| 1942713417 | Pakravan Dental Corporation | Dentist | 2440 River Road, Suite 140, Norco, CA 92860 | 2017-11-07 |
| 1003202938 | Christina Cowell | Dental Assistant | 4033 Bluff St, Noroc, CA 92860 | 2015-04-07 |
| 1811301575 | Kenneth John Conlan | Counselor | 630 Winchester Dr., Norco, CA 92860 | 2014-06-19 |
| 1336489384 | Hyangsook Jung | Psychologist | 5th St. and Western Ave., Norco, CA 92860 | 2013-02-27 |
| 1386913275 | Shirley Nguyen | Pharmacist | 5th Street & Western Avenue, Norco, CA 92860 | 2011-12-21 |
| 1609168301 | Nicole Nadine Ortiz | Occupational Therapist | 2820 Clark Ave., Norco, CA 92860 | 2011-05-12 |
| 1861793739 | Peter A Petito | Psychologist | 5th and Western Ave., California Rehabilitation Center, Norco, CA 92860 | 2010-11-09 |
| Find all providers in zip 92860 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 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.