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General NPI Number Information
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NPI Number | 1811968761
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Entity Type | Organization
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Legal Business Name | SATELLITE DIALYSIS OF CAPITOLA LLC
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 3801 CLARES ST
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City | CAPITOLA
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State | CA
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Zip | 95010-2537
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Country | US
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Telephone | 831-600-4600
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Fax | 831-462-3401
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Provider Business Mailing Address
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Address Line | 300 SANTANA ROW STE 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 | 831-600-4600
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Fax | 650-625-6007
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Authorized Official
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Title or Position | CHAIRMAN
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Name | THOMAS L WEINBERG
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Credential |
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Telephone | 214-736-2700
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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 | 140000635
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License Number State | CA
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