NPIMap

Organization Active NPI

Dva Healthcare Renal Care Inc

Doing business as East LA Plaza Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1235104159
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
930000341 Issued in CA
Legal business name
DVA HEALTHCARE RENAL CARE INC
Doing business as
East LA Plaza Dialysis
Practice address
1700 E Cesar E Chavez Ave
Ste L 100
Los Angeles, CA 90033-2472
Phone
(323) 261-0484
Fax
(323) 261-5348
NPI assigned
Feb 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 930000341 CA Primary

Addresses

Primary practice location

1700 E Cesar E Chavez Ave
Ste L 100
Los Angeles, CA 90033-2472

Mailing address

5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
1235104159MedicaidCA

Other names 1

  • East LA Plaza Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030428000021 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: Los Angeles, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita East LA Plaza DialysisCCN 052622
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Apr 11, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
30

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0963368East la Plaza Dialysis1700 Cesar E Chavez Blvd, Suite L100, Los Angeles, CA 90033Certificate of waiverNov 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Columbia Central194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1235104159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "address_2": "STE L 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332472",
            "telephone_number": "323-261-0484",
            "fax_number": "323-261-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "930000341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235104159",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East LA Plaza Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East LA Plaza Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.