MEDICARE: DOLORES DIALYSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	5500001638	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033429287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLORES DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30885 DATE PALM DR
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-2958
Country	:	US
Telephone Number	:	760-202-3491
Fax Number	:	760-202-7015

Authorized Official
Title or Position	:	VP, LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	11/04/2024

Similar Medicare Providers

1346616471 — NORIKO UTSUZAWA MS, LMT, CD
Practice Location Address:

2918 HUCKLEBERRY ST
MISSOURI CITY, TX
77459-2958

Practice Phone: 281-633-6246
Practice Fax:

1396961140 — TAMRA J COLEMAN PT
Practice Location Address:

1977 ACOMA BLVD W
LAKE HAVASU CITY, AZ
86403-2958

Practice Phone: 928-302-5323
Practice Fax:

1700055050 — DR. HEATHER ANN GOODSPEED D.C.
Practice Location Address:

200 PROVIDENCE MINE RD , #108
NEVADA CITY, CA
95959-2958

Practice Phone: 530-264-6368
Practice Fax: 530-687-8109

1871729939 — SPECIALIZED ORTHOTIC & PROSTHETIC TECHNOLOGIES
Practice Location Address:

5292 COLLEGE DR STE 103
SALT LAKE CITY, UT
84123-2958

Practice Phone: 801-266-7768
Practice Fax:

1629440169 — MS. CLAUDIA CHAVARRO HULSBERG LMHC
Practice Location Address:

1020 BLOSSOM ST
PANAMA CITY, FL
32405-2958

Practice Phone: 904-859-8073
Practice Fax:

1205292240 — TRUSTED HANDS HOME HEALTHCARE SERVICES LLC
Practice Location Address:

5120 PROSPECT AVE
KANSAS CITY, MO
64130-2958

Practice Phone: 816-446-2752
Practice Fax:

Directions to “DOLORES DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.