Healthcare Provider Details

I. General information

NPI: 1699025460
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 E LA PALMA AVE
ANAHEIM CA
92807-1815
US

IV. Provider business mailing address

5200 VIRGINIA WAY L&C DEPT
BRENTWOOD TN
37027-7569
US

V. Phone/Fax

Practice location:
  • Phone: 714-996-2900
  • Fax: 714-996-2969
Mailing address:
  • Phone: 615-341-6793
  • Fax: 877-790-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number550000052
License Number StateCA

VIII. Authorized Official

Name: JOHN D. WINSTEL
Title or Position: CHIEF ACCOUNTING OFFICER
Credential:
Phone: 253-733-4501