Cudahy Peritoneal Dialysis Center

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Cudahy, CA

NPI 1275158487 · NPPES record last updated Oct 7, 2020

Key facts

NPI
1275158487
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
CUDAHY PERITONEAL DIALYSIS CENTER
Practice address
4566 Florence Ave Ste 3
Cudahy, CA 90201-4346
Phone
(323) 749-5360
NPI assigned
Jun 12, 2020
Organization subpart
No

Authorized official

Name
Dr. Marco A Martinez, MD
Title
President
Phone
(323) 749-5360

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare Care Compare: Dialysis facility

Listed as
Cudahy Peritoneal Dialysis Center CCN 752535
Overall star rating
★★★☆☆ 3.0 of 5
Ownership
Profit
Certified
Dec 28, 2021
Medicare certification status
Active (Provider of Services file)
Dialysis stations
2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20201130002379 CA Part a Provider - End-Stage Renal Disease Facility (ESRD) 1850702648 Practice locations: Cudahy, CA

National Provider Directory

Locations

4566 Florence Ave
Ste 3
Bell, CA 90201
Phone (323) 562-0055

Specialties & licenses

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

Addresses

Primary practice location

4566 Florence Ave Ste 3
Cudahy, CA 90201-4346

Mailing address

4566 Florence Ave Ste 3
Cudahy, CA 90201-4346
Phone (323) 749-5360

Other names

  • Cudahy Peritoneal Dialysis Center Former legal business name

Electronic endpoints

TypeEndpointUseAffiliation
Other URL faz Health Information Exchange (HIE)

Other providers in Cudahy, CA

All providers in Cudahy, CA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.