Organization Name: | RAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC |
NPI Number: | 1003989732 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK R. FAWCETT (TREASURER) |
Mailing Address: | 1210 Indiana Ct Redlands |
State: | CA US |
Postal Code: | 923742896 |
Phone Number: | 9097928880 |
Fax Number: | 9097984154 |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 07/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |