Bohama Dialysis LLC

Primary specialty

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

Legal business name

BOHAMA DIALYSIS LLC

Practice address

8219 Rochester Ave
Ste 120
Rancho Cucamonga, CA 91730-0723

Phone

(909) 466-5489

Fax

(909) 477-2098

NPI assigned

Feb 20, 2013

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rancho Cucamonga Home Training Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita Rancho Cucamonga Home TrainingCCN 552757

Ownership

Profit

Certified

Jan 23, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

10

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

CLIA laboratory certificates

Member of 2

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Castle Rock, CO
  • NPI 1386928430

  Member Of

  NPD member
• Total Renal Care Inc

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

  Member Of

  NPD member

Affiliated clinicians 6

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

• Mary Phuong Bui

  • Nephrology Physician
  • Upland, CA
  • NPI 1841225224

  Dialysis facility

  Care Compare affiliation Name & address match
• Minna F Huang, M.D.

  • Nephrology Physician
  • Upland, CA
  • NPI 1841447745

  Dialysis facility

  Care Compare affiliation Name & address match
• Solomon Christopher Huang, M.D.

  • Nephrology Physician
  • Upland, CA
  • NPI 1184939381

  Dialysis facility

  Care Compare affiliation Name & address match
• Nima Naimi, D.O.

  • Nephrology Physician
  • Upland, CA
  • NPI 1740424712

  Dialysis facility

  Care Compare affiliation Name & address match
• Saman Sarani, M.D.

  • Nephrology Physician
  • Upland, CA
  • NPI 1124333141

  Dialysis facility

  Care Compare affiliation Name & address match
• Chirag Vaidya, MD

  • Nephrology Physician
  • Upland, CA
  • NPI 1073654570

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1497095905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "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": "8219 ROCHESTER AVE",
            "address_2": "STE 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300723",
            "telephone_number": "909-466-5489",
            "fax_number": "909-477-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOHAMA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497095905",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rancho Cucamonga Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rancho Cucamonga Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gizel Bocanegra Lopez
• Bodylogics Health Services Inc.
• Randy Lee Boeglin Jr.
• Mary Allison Bogdis
• Katie Kristine Bogh
• Stephanie Emily Boian
• Maritza Bojorquez, LCSW
• Marta Diaz Bomortino, LCSW
• Karina Bond
• Ana Bondari

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• 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 29, 2024; 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.