Usc-Davita Dialysis Center, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

USC-DAVITA DIALYSIS CENTER, LLC

Practice address

3660 Wilshire Blvd Ste 338
Los Angeles, CA 90010-2752

Phone

(213) 900-1416

Fax

(213) 900-1438

NPI assigned

May 24, 2021

Organization subpart

No

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

Addresses

Other names 1

• USC Korea Town Home Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Usc-Davita Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1639132772

  5395759625

  Same PAC ID

Listed as

DaVita USC Korea Town Home DialysisCCN 752544

Ownership

Profit

Certified

May 12, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

6

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

CLIA laboratory certificates

Tax ID family

TRC Usc Kidney Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Usc-Davita Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1639132772
  NPD tax ID

Member of 3

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

• University of Southern California

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1881727220

  Member Of

  NPD member
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Beverly Hills, CA
  • NPI 1972367217

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Practitioners 1

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

• Arshia Ghaffari, D.O.

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1235236183
  NPD (past)

Affiliated clinicians 1

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

• Fadi Tohme, MD

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1336437730

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1376118281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATTN: L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 WILSHIRE BLVD STE 338",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102752",
            "telephone_number": "213-900-1416",
            "fax_number": "213-900-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USC-DAVITA DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USC Korea Town Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "USC Korea Town Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Usc University Hospital
• Usc University Hospital, Inc.
• Usc University Hospital, Inc.
• Usc Urgent Care
• Usc-Davita Dialysis Center LLC
• Usc-Telehealth
• Uscan Anesthesiology Medical Group, Inc.
• Yatziry Uscanga
• Uscc Aquisition Corp
• Uscth

• All providers in Los Angeles, CA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.