NPIMap

Organization Active NPI

Dva Renal Healthcare Inc

Doing business as College Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
National Provider Identifier
1902870330
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
080000775 Issued in CA
Legal business name
DVA RENAL HEALTHCARE INC
Doing business as
College Dialysis
Practice address
6535 University Ave
San Diego, CA 92115-6341
Phone
(619) 287-8796
Fax
(619) 287-4862
NPI assigned
Feb 14, 2006
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 080000775 CA Primary

Addresses

Primary practice location

6535 University Ave
San Diego, CA 92115-6341

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1902870330MedicaidCA

Other names 1

  • College Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021119000000 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Tax ID family
Dva Renal Healthcare Inc173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

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

View all 15

Locations

6535 University Ave
San Diego, CA 92115
Phone (619) 287-8796

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1902870330",
    "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": "6535 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156341",
            "telephone_number": "619-287-8796",
            "fax_number": "619-287-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "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": "080000775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902870330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "College Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.