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General NPI Number Information
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NPI Number | 1376859108
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Entity Type | Organization
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Legal Business Name | SATELLITE DIALYSIS OF LYNWOOD LLC
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 8716 GARFIELD AVE STE 100
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City | SOUTH GATE
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State | CA
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Zip | 90280-3723
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Country | US
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Telephone | 562-674-2600
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Fax | 562-928-9304
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Provider Business Mailing Address
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Address Line | 300 SANTANA ROW SUITE 300
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City | SAN JOSE
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State | CA
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Zip | 95128-2423
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Country | US
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Telephone | 562-674-2600
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Fax | 650-625-6007
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Authorized Official
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Title or Position | COMPLIANCE & RISK DIRECTOR
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Name | MARGARITA GUIZAR
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Credential |
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Telephone | 650-404-3771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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