Organization · Type 2 NPI

Mulgee Dialysis LLC

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

NPI number 1710229794 Active

Practice location

14204 Prairie Ave
Hawthorne, CA 90250-7908

Call (310) 349-1174 Map

Fax (310) 349-1903

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	550002530 (CA)

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

NPI record

NPI: 1710229794
Entity type: Organization (Type 2)
Issued: Mar 18, 2013
Last updated: Oct 23, 2026
Status: Active

Other names

<unavail>
Hawthorne Dialysis · doing business as
Hawthorne Dialysis · doing business as

Authorized official

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

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1710229794

Mulgee Dialysis LLC's National Provider Identifier is 1710229794, issued on Mar 18, 2013. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Hawthorne, CA. The record was last updated on Oct 23, 2026.