DVA RENAL HEALTHCARE INC (NPI# 1093780017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093780017 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | SAN DIEGO SOUTH DIALYSIS |
| Practice Address |
995 Gateway Center Way Ste 101 San Diego CA 92102-4550 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 6192621960 |
| Practice Fax Number | 6192622420 |
| Mailing Telephone | 6153416765 |
| Mailing Fax Number | 8337829089 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-05-13 |
| Authorized Official Name | JOHN D. WINSTEL SR. (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
080000705 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1093780017 | 05 | |
| LA | 1791954 | 05 |
| Other Name | Type Code |
|---|---|
| San Diego South Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629415609 | Dva Renal Healthcare Inc | Clinic/Center | 300 B 22nd St South, Birmingham, AL 35233-2209 | 2013-05-30 |
| 1164728408 | Dva Renal Healthcare Inc | Clinic/Center | 415 W Nc Hwy 54, Durham, NC 27713-7516 | 2011-02-03 |
| 1295983245 | Dva Renal Healthcare Inc | Clinic/Center | 1919 Charlotte Ave Ste 200, Nashville, TN 37203-2245 | 2008-09-03 |
| 1811171440 | Dva Renal Healthcare Inc | Clinic/Center | 300 W Broadway Ste 150, Council Bluffs, IA 51503-9077 | 2007-12-18 |
| 1881623585 | Dva Renal Healthcare Inc | Clinic/Center | 271 King St, Perth Amboy, NJ 08861-4488 | 2006-07-03 |
| 1164451852 | Dva Renal Healthcare Inc | Clinic/Center | 262 Texas Rd, Ste 101, Old Bridge, NJ 08857-4008 | 2006-07-03 |
| 1912936618 | Dva Renal Healthcare Inc | Clinic/Center | 1200 Randolph Rd, Muhlenburg Campus, Plainfield, NJ 07060-3361 | 2006-07-03 |
| 1346270782 | Dva Renal Healthcare Inc | Clinic/Center | 230 Van Sciver Pkwy, Willingboro, NJ 08046-1131 | 2006-07-03 |
| 1548299381 | Dva Renal Healthcare Inc | Clinic/Center | 29 Meridian Rd, Edison, NJ 08820-2823 | 2006-07-02 |
| 1548299373 | Dva Renal Healthcare Inc | Clinic/Center | 14-20 Prospect St, East Orange, NJ 07017-2238 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA Renal Healthcare Inc. | 2000 16th St, Jld/secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
995 GATEWAY CENTER WAY STE 101 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92102-4550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912564683 | Andrea Rita Meza | Counselor | 995 Gateway Center Way, San Diego, CA 92102-4500 | 2019-05-28 |
| 1114497732 | Melanie Munoz | Student in an Organized Health Care Education/Training Program | 995 Gateway Center Way, San Diego, CA 92102-4500 | 2018-11-26 |
| 1730673831 | Kaylee Mae Marzoni | Social Worker | 995 Gateway Center Way, San Diego, CA 92102 | 2018-06-21 |
| 1366936072 | Julia Wadensweiler | Registered Nurse | 995 Gateway Center Way, San Diego, CA 92102 | 2018-06-15 |
| 1801307350 | Crystal Vernell Phillip | Counselor | 995 Gateway Center Way, San Diego, CA 92102-4500 | 2017-10-23 |
| 1154856482 | Nathaniel Cameron Dressel | Counselor | 995 Gateway Center Way, Suite 300, San Diego, CA 92102-4500 | 2017-04-24 |
| 1811438997 | Rattner Vascular Medical Center Asc LLC | Clinic/Center | 995 Gateway Center Way, Suite 207, San Diego, CA 92102-4500 | 2017-03-09 |
| 1679024004 | Ciara Perkins | Counselor | 995 Gateway Center Way, San Diego, CA 92102-4500 | 2016-10-20 |
| 1588114763 | Alexis Page Wilson | Counselor | 995 Gateway Center Way, 300, San Diego, CA 92102-4500 | 2016-10-11 |
| 1780137141 | Nathan Aish | Counselor | 995 Gateway Center Way, Suite 300, San Diego, CA 92102-4500 | 2016-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766698 | Daniela Tablas | Behavioral Analyst | 303 47th St Spc D-22, San Diego, CA 92102 | 2020-09-30 |
| 1649745712 | Juliet Lao Kurek | Pharmacist | 2121 Imperial Avenue, San Diego, CA 92102 | 2018-10-04 |
| 1851887020 | Monique Joseph | Counselor | 2410 E. Street, San Diego, CA 92102 | 2018-07-10 |
| 1184166316 | Elise Blanton-hubbard | Counselor | 1850 Dale St, San Diego, CA 92102 | 2016-11-04 |
| 1699221416 | Kari Judith Medina | Student in an Organized Health Care Education/Training Program | 1199 34th Street Apt 11, San Diego, CA 92102 | 2016-08-31 |
| 1942674536 | Caitlin Hillary Dablow | Speech-Language Pathologist | 1201 34th Street, San Diego, CA 92102 | 2015-11-19 |
| 1134508179 | Jonathan Waters | Military Health Care Provider | 1233 22nd Street, Unit 8, San Diego, CA 92102 | 2015-05-22 |
| 1871989913 | Abraham Greenberg | Pediatrics | 15 Balfour Street, Jerusalem, ISRAEL 92102 | 2015-04-15 |
| 1023421021 | Elmira Aghdam | Chiropractor | 5030 Bonita Rd Ste#b, Bonita, CA 92102 | 2014-06-06 |
| 1487092540 | Sherry Scott | Marriage & Family Therapist | 995 Gateway Center Drive #300, San Diego, CA 92102 | 2013-06-11 |
| Find all providers in zip 92102 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366834285 | Bio-medical Applications of California, Inc. | Clinic/Center | 499 Raven St, San Diego, CA 92102-4525 | 2015-03-02 |
| 1376784389 | Fresenius Medical Care Balboa, LLC | Clinic/Center | 7927 Ostrow St, Suite A, San Diego, CA 92111-3604 | 2009-03-20 |
| 1053443101 | Bio-medical Applications of California, Inc. | Clinic/Center | 4765 Carmel Mountain Rd Ste 100, San Diego, CA 92130-6657 | 2007-03-12 |
| 1114091840 | Rai Care Centers of Southern California II, LLC | Clinic/Center | 7007 Mission Gorge Rd, Suite A, San Diego, CA 92120-2418 | 2006-11-17 |
| 1700988128 | San Diego Dialysis Services, Inc. | Clinic/Center | 663 33rd St, San Diego, CA 92102-3300 | 2006-09-05 |
| 1619079035 | San Diego Dialysis Services, Inc. | Clinic/Center | 3010 Del Sol Blvd, San Diego, CA 92154-3475 | 2006-09-05 |
| 1740392547 | San Diego Dialysis Services, Inc. | Clinic/Center | 3960 3rd Ave, San Diego, CA 92103-3003 | 2006-08-31 |
| 1477665271 | San Diego Dialysis Services, Inc. | Clinic/Center | 2252 Verus St, San Diego, CA 92154-4707 | 2006-08-31 |
| 1568574366 | San Diego Dialysis Services, Inc. | Clinic/Center | 7927 Ostrow St Ste A, Suite A, San Diego, CA 92111-3604 | 2006-08-31 |
| 1386756187 | San Diego Dialysis Services, Inc. | Clinic/Center | 720 Gateway Center Dr, Suite B, San Diego, CA 92102-4549 | 2006-08-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.