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General NPI Number Information
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NPI Number | 1760923445
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Entity Type | Organization
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Legal Business Name | DIALYSIS ACCESS CENTER A MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 3012 SUMMIT ST D WING
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City | OAKLAND
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State | CA
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Zip | 94609-3480
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Country | US
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Telephone | 510-251-1002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 883528
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City | LOS ANGELES
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State | CA
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Zip | 90088-3528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | THOMAS A. TURNER
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Credential |
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Telephone | 510-251-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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