DAVITA RIVERSIDE II LLC (NPI# 1316971641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316971641 |
| Entity Type | Organization |
| Organization Name | DAVITA RIVERSIDE II LLC |
| Other Organization Name | MAGNOLIA WEST DIALYSIS |
| Practice Address |
11161 Magnolia Ave Riverside CA 92505-3605 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9513518090 |
| Practice Fax Number | 9513518099 |
| Mailing Telephone | 6153416793 |
| Mailing Fax Number | 8777902174 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | JOHN 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 |
550000177 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1316971641 | 05 |
| Other Name | Type Code |
|---|---|
| Magnolia West Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033159264 | Davita Riverside II LLC | Clinic/Center | 1901 Town and Country Dr Ste 100, Norco, CA 92860-3611 | 2006-06-07 |
| Street Address |
11161 MAGNOLIA AVE |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92505-3605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972810059 | Millicent Santos Elizalde | Dietitian, Registered | 11161 Magnolia Ave, Riverside, CA 92505-3605 | 2010-09-10 |
| 1518082718 | Darcie E Nagel | Dietitian, Registered | 11161 Magnolia Ave, Riverside, CA 92505-3605 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205458460 | Mark Anthony Vargas | Behavioral Analyst | 94193 Flat Rock Dr Ste 220, Riverside, CA 92505 | 2020-05-11 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1588222087 | A Homecare Services, Inc | In Home Supportive Care | 4193 Flat Rock Road, Building 200 Suite 206, Riverside, CA 92505 | 2019-05-31 |
| 1609302397 | Tap Pharmacy, Inc. | Pharmacy | 4270 Riverwalk Pkwy Ste 102, Riverside, CA 92505 | 2017-05-02 |
| 1467998658 | Onofre Gascon | Behavior Technician | 11711 Collett Ave, #1614, Riverside, CA 92505 | 2017-01-11 |
| 1780038505 | Nash David Martinez | Emergency Medicine | 10800 Magnolia Ave Dept of Emergency Medicine, Kaiser Permanente Hospital, Riverside, CA 92505 | 2016-04-18 |
| 1447639901 | Jose Joel Manalese Dds Inc | Dentist | 3950 Pierce St., Suite L., Riverside, CA 92505 | 2015-05-29 |
| 1821493230 | Jean Huynh | Physician Assistant | 11725 State Ave., Suite 100, Riverside, CA 92505 | 2014-10-28 |
| 1003160649 | Elaf Farahat | Dietitian, Registered | 10800 Magnolia Avenue., Riverside, CA 92505 | 2012-11-05 |
| 1730458217 | Tammy Lynn Gilmore | Non-emergency Medical Transport (VAN) | 10770 Hole Avenue, 106, Riverside, CA 92505 | 2011-12-29 |
| Find all providers in zip 92505 | ||||
| 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 |
|---|---|---|---|---|
| 1003396615 | Tricity Riverside Dialysis | Clinic/Center | 7275 Indiana Ave, Riverside, CA 92504-4543 | 2018-08-14 |
| 1215332945 | Iroquois Dialysis LLC | Clinic/Center | 3660 Park Sierra Dr Ste 103, Riverside, CA 92505-3071 | 2014-10-23 |
| 1306240551 | Iroquois Dialysis LLC | Clinic/Center | 3660 Park Sierra Dr Ste 108, Riverside, CA 92505-3071 | 2014-10-17 |
| 1538271333 | Bio-medical Applications of California Inc | Clinic/Center | 3470 La Sierra Ave Ste E, Riverside, CA 92503-5223 | 2006-08-31 |
| 1033172135 | Renal Treatment Centers California Inc | Clinic/Center | 4361 Latham St Ste 100, Riverside, CA 92501-1767 | 2006-04-10 |
| 1245567627 | Mk Dialysis Center At Riverside, Inc. | Clinic/Center | 3595 Van Buren Blvd, Suite 101, Riverside, CA 92503-0311 | 2009-11-05 |
| 1144427741 | Namg Home Dialysis LLC | Clinic/Center | 3660 Park Sierra Dr, Ste 103, Riverside, CA 92505-3081 | 2007-06-28 |
| 1013119064 | Namg Home Dialysis LLC | Clinic/Center | 3660 Park Sierra Dr, Ste 108, Riverside, CA 92505-3081 | 2007-06-01 |
| 1922153576 | Kaiser Foundation Hospitals | Clinic/Center | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2007-01-24 |
| 1811941891 | Riverside Healthcare System, L.p. | Clinic/Center | 4445 Magnolia Ave, Riverside, CA 92501-4135 | 2006-05-22 |
| Find all providers in RIVERSIDE | ||||
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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.