HOME DIALYSIS CENTERS OF RANCHO CUCAMONGA LLC NPI 1720314982

NPI Information

  • NPI: 1720314982
  • Provider Name: HOME DIALYSIS CENTERS OF RANCHO CUCAMONGA LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: HOME DIALYSIS CENTERS
  • CLIA Number: 05D2150341
  • Address: 8239 ROCHESTER AVE
    SUITE 110
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Phone: (909) 945-2104

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NPI Details

HOME DIALYSIS CENTERS OF RANCHO CUCAMONGA LLC is an end-stage renal disease (esrd) treatment clinic center in Rancho Cucamonga, CA. HOME DIALYSIS CENTERS OF RANCHO CUCAMONGA LLC NPI is 1720314982. The provider is registered as an organization entity type.
The provider Is Doing Business As Home Dialysis Centers.

The provider's business location address is:

8239 ROCHESTER AVE
SUITE 110
RANCHO CUCAMONGA, CA
ZIP 91730-714
Phone: (909) 945-2104
Fax: (909) 945-2152

The provider's authorized official is Shawn Mehrabian .
The authorized official title is Director Of Operations and has the following contact phone number (818) 939-2047.

The CLIA number assigned to this NPI record is 05D2150341 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2009 and was last updated on 4/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11720314982MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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