NPIMap

Organization Active NPI

Dva Healthcare Renal Care Inc

Doing business as Imperial Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Inglewood, CA
National Provider Identifier
1790759744
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
930000427 Issued in CA
Legal business name
DVA HEALTHCARE RENAL CARE INC
Doing business as
Imperial Dialysis
Practice address
2738 W Imperial Hwy
Inglewood, CA 90303-3111
Phone
(323) 779-5399
Fax
(323) 779-5651
NPI assigned
Feb 15, 2006
Last updated
Feb 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 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 930000427 CA Primary

Addresses

Primary practice location

2738 W Imperial Hwy
Inglewood, CA 90303-3111

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1790759744MedicaidCA

Other names 1

  • Imperial Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030428000017 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: Inglewood, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Imperial DialysisCCN 052670
Overall star rating
2.0 of 5
Ownership
Profit
Certified
May 19, 1988
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
05D0549343Imperial Dialysis2738 W Imperial Hwy, Inglewood, CA 90303Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Dialysis Services194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

Member of 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1790759744",
    "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": "2738 W IMPERIAL HWY",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903033111",
            "telephone_number": "323-779-5399",
            "fax_number": "323-779-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "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": "930000427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790759744",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Imperial Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.