Healthcare Provider Details

I. General information

NPI: 1942528203
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 HIGH ST
SELMA CA
93662-3512
US

IV. Provider business mailing address

15253 BAKE PARKWAY
IRVINE CA
92618
US

V. Phone/Fax

Practice location:
  • Phone: 559-992-7100
  • Fax: 559-992-7299
Mailing address:
  • Phone: 949-930-6874
  • Fax: 866-639-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICOLE CLARKE
Title or Position: ARRM
Credential:
Phone: 949-930-6874