Healthcare Provider Details

I. General information

NPI: 1164794715
Provider Name (Legal Business Name): SATELLITE DIALYSIS OF OAKLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2012
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 2ND ST
OAKLAND CA
94607-4307
US

IV. Provider business mailing address

5851 LEGACY CIR STE 900
PLANO TX
75024-5982
US

V. Phone/Fax

Practice location:
  • Phone: 510-433-8340
  • Fax: 510-547-1444
Mailing address:
  • Phone: 650-404-3600
  • Fax: 650-625-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: THOMAS L WEINBERG
Title or Position: CHAIRMAN
Credential:
Phone: 214-726-2700