Healthcare Provider Details

I. General information

NPI: 1366405730
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 PLUMAS CT STE A
YUBA CITY CA
95991-2971
US

IV. Provider business mailing address

5200 VIRGINIA WAY STE 400 L&C
BRENTWOOD TN
37027-7569
US

V. Phone/Fax

Practice location:
  • Phone: 530-671-3652
  • Fax: 530-671-4903
Mailing address:
  • Phone: 615-320-4435
  • Fax: 866-317-3596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number110000481
License Number StateCA

VIII. Authorized Official

Name: THOMAS O USILTON JR.
Title or Position: GROUP VICE PRESIDENT
Credential:
Phone: 770-541-7922