Organization · Type 2 NPI

Huntington Park Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Huntington Park, CA

NPI number 1124261854 Active

Practice location

5942 Rugby Ave.
Huntington Park, CA 90255-2803

Call (323) 585-7605 Map

Fax (323) 585-7635

Mailing address

5200 Virginia Way, L&c Dept.
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	550001465 (CA)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1124261854
Entity type: Organization (Type 2)
Issued: Apr 10, 2009
Last updated: Nov 28, 2023
Status: Active

Other names

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Huntington Park Dialysis · doing business as
Huntington Park Dialysis · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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About NPI 1124261854

Huntington Park Dialysis LLC's National Provider Identifier is 1124261854, issued on Apr 10, 2009. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Huntington Park, CA. The record was last updated on Nov 28, 2023.