SATELLITE DIALYSIS OF LYNWOOD LLC


Address: 8716 Garfield Ave, Ste 100, South Gate, CA 90280-3723
Phone: 5626742600

SATELLITE DIALYSIS OF LYNWOOD LLC (NPI# 1376859108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376859108
Entity Type Organization
Organization Name SATELLITE DIALYSIS OF LYNWOOD LLC
Practice Address 8716 Garfield Ave
Ste 100
South Gate
CA 90280-3723
Mailing Address 300 Santana Row
Suite 300
San Jose
CA 95128-2423
Practice Telephone 5626742600
Practice Fax Number 5629289304
Mailing Telephone 5626742600
Mailing Fax Number 6506256007
Enumeration Date 2010-08-31
Last Update Date 2020-04-29
Authorized Official Name MARGARITA GUIZAR (COMPLIANCE & RISK DIRECTOR)
Authorized Official Telephone 6504043771
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA 1376859108 05
CA STATE LICENSE 550001699 01
CA CLIA CERTIFICATE OF WAIVER 05D2020393 01

Other Provider/Organization Names

Other Name Type Code
Satellite Healthcare South Gate Doing Business As Name - Organization

Office Location

Street Address 8716 GARFIELD AVE
STE 100
City SOUTH GATE
State CA
Zip Code 90280-3723

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Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

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1184004137 Olive Dialysis LLC Clinic/Center 9848 Atlantic Ave, South Gate, CA 90280-5219 2015-06-04

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Competitor

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City SOUTH GATE
Zip Code 90280

Improve Information

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Dataset Information

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.

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