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NPI Code Detail

MEDICARE: HSRENAL LLC

MEDICARE: HSRENAL 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
12472R0900XRenal Dialysis Technician

General Provider Information

NPI Number : 1588214738
Entity Type Code : Organization
Provider Name (Legal Business Name) : HSRENAL LLC
Provider Business Mailing Address
First Line : 16925 BELLFLOWER BLVD
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-5903
Country : US
Telephone Number : 714-323-5157
Fax Number :
Provider Business Practice Location Address
First Line : 16925 BELLFLOWER BLVD
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-5903
Country : US
Telephone Number : 714-323-5157
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL LEE
Credential :
Telephone Number : 714-323-5157
Provider Enumeration Date : 09/18/2019
Last Update Date : 09/18/2019

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Directions to “HSRENAL LLC ” Practice Location

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