Port City Dialysis

LBN: Coral Dialysis Llc
Port City Dialysis is an health care organization with primary practice located at 1810 S Fresno Ave , Stockton CA 95206-1861. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Coral Dialysis Llc can be contacted via phone (209) 946-0738, or through Winstel, John via phone (253) 733-4501.

Contact Information

Primary practice address
1810 S Fresno Ave Stockton CA 95206-1861
Phone: (209) 946-0738
Fax: (209) 946-0827
Website:
Map and Directions
Authorized official contact:
Name: Winstel, John
Phone: (253) 733-4501

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1437569514
LBN Legal business name Coral Dialysis Llc
DBA Doing business as Port City Dialysis
Authorized official Winstel, John
Entity Organization
Organization subpart 1 No
Enumeration date Apr 29th, 2014
Last updated Apr 10th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437569514 NPPES
California MEDICAID 1437569514

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