DVA RENAL HEALTHCARE INC (NPI# 1588638191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588638191 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | AIRPORT DIALYSIS |
| Practice Address |
4632 W Century Blvd Inglewood CA 90304-1456 |
| Mailing Address |
5200 Virginia Way L&c 4th Fl Brentwood TN 37027-7569 |
| Practice Telephone | 3106774262 |
| Practice Fax Number | 3106771034 |
| Mailing Telephone | 6153415895 |
| Mailing Fax Number | 8668905560 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2013-01-03 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2532809501 |
| 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 |
930000862 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1588638191 | 05 |
| Other Name | Type Code |
|---|---|
| Airport 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 |
4632 W CENTURY BLVD |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90304-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497736938 | Jabir Rahman Sharif | Internal Medicine | 4632 W Century Blvd, Ste A, Inglewood, CA 90304-1454 | 2005-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639164 | Elizabeth Jett | Technician | 5527 W. 119th Place, Inglewood, CA 90304 | 2019-09-26 |
| 1376099267 | Makasha Sims | Licensed Vocational Nurse | 4450 W. Century Bld., Inglewood, CA 90304 | 2016-08-30 |
| 1528309655 | Ma Roxanne Fermin | Optometrist | 11964 Aviation Blvd, Los Angeles, CA 90304 | 2013-03-14 |
| 1295958353 | Hossein Javid | Dentist | 11976 Aviation Blvd, Inglewood, CA 90304 | 2007-04-10 |
| 1063952554 | Samantha Michelle Kirzner | Dentist | 4201 W Century Blvd, Inglewood, CA 90304 | 2017-03-02 |
| 1639557218 | Priority Vision Optometry Inc | Optometrist | 11964 Aviation Blvd, Los Angeles, CA 90304 | 2015-05-14 |
| 1538436811 | Harmik Torosian | Chiropractor | 11968 Aviation Blvd, Inglewood, CA 90304-1001 | 2011-11-30 |
| 1114310505 | Kian M Javid | Chiropractor | 11968 Aviation Blvd, Inglewood, CA 90304-1001 | 2015-03-10 |
| 1104261353 | Javid Brothers | Dentist | 11976 Aviation Blvd, Inglewood, CA 90304-1001 | 2013-05-01 |
| 1235480963 | South Bay Wellness Center | Chiropractor | 11968 Aviation Blvd, Inglewood, CA 90304-1001 | 2012-09-20 |
| Find all providers in zip 90304 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 1912071564 | Rai Care Centers of Southern California II, LLC | Clinic/Center | 1416 Centinela Ave, Inglewood, CA 90302-1142 | 2006-11-17 |
| 1881706687 | Bio-medical Applications of California, Inc. | Clinic/Center | 301 N Prairie Ave Ste 100, Inglewood, CA 90301-4508 | 2006-08-31 |
| 1477503654 | Bio-medical Applications of California, Inc. | Clinic/Center | 336 E Hillcrest Blvd, Suite 100, Inglewood, CA 90301-2406 | 2006-05-11 |
| 1902869035 | Total Renal Care Inc | Clinic/Center | 11300 Hawthorne Blvd, Inglewood, CA 90304-2715 | 2006-04-10 |
| 1790759744 | Dva Healthcare Renal Care Inc | Clinic/Center | 2738 W Imperial Hwy, Inglewood, CA 90303-3111 | 2006-02-15 |
| 1174597033 | Dva Healthcare Renal Care Inc | Clinic/Center | 125 E Arbor Vitae St, Inglewood, CA 90301-3839 | 2006-02-15 |
| 1245354687 | Angel Kidney Care of Inglewood Inc | Clinic/Center | 994 S La Brea Ave, Inglewood, CA 90301-3816 | 2007-03-19 |
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| 1659994903 | Bio Medical Applications of California Inc | Clinic/Center | 1287 N Hacienda Blvd, La Puente, CA 91744-1631 | 2020-05-21 |
| 1245853654 | Culbert Dialysis LLC | Clinic/Center | 4223 E Anaheim St, Long Beach, CA 90804-4202 | 2020-05-20 |
| 1790308179 | Palo Dialysis LLC | Clinic/Center | 10211 Long Beach Road, Lynwood, CA 90262-1508 | 2020-05-20 |
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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.