Palomar Dialysis LLC

Primary specialty

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

License

5500001188 Issued in CA

Legal business name

PALOMAR DIALYSIS LLC

Practice address

3201 Doolan Rd
Ste 175
Livermore, CA 94551-9610

Phone

(925) 245-9780

Fax

(925) 245-9785

NPI assigned

Apr 8, 2009

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 identifiers 1

Other names 1

• Livermore Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita Livermore DialysisCCN 552638

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Feb 3, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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 1

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
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Affiliated clinicians 5

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

• Deepika Kancherla, M.D

  • Nephrology Physician
  • Concord, CA
  • NPI 1790963726

  Dialysis facility

  Care Compare affiliation Name & address match
• Peter Alan Lee, MD

  • Nephrology Physician
  • Pleasanton, CA
  • NPI 1982857462

  Dialysis facility

  Care Compare affiliation Name & address match
• Leena K Mehandru, M.D.

  • Nephrology Physician
  • Pleasanton, CA
  • NPI 1427096452

  Dialysis facility

  Care Compare affiliation Name & address match
• Rahul Rishi, M.D.

  • Nephrology Physician
  • Castro Valley, CA
  • NPI 1740243930

  Dialysis facility

  Care Compare affiliation Name & address match
• Anne Yu, MD

  • Nephrology Physician
  • San Leandro, CA
  • NPI 1114283314

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1700029642",
    "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": "3201 DOOLAN RD",
            "address_2": "STE 175",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945519610",
            "telephone_number": "925-245-9780",
            "fax_number": "925-245-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOMAR DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "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": "5500001188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700029642",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livermore Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Livermore Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adam Christian Paiso, D.C.
• Sandy Pak, PHARMD
• Monnique Palana, NP
• Palo Alto Vamc
• Palo Alto Vamc
• June Pan, MD
• Diana Pardo
• Thomas D Parker, PTA
• Prexxie Pascual, RN
• Roxanne Passama

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Livermore, CA
• Providers in Livermore, 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 Dec 16, 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.