Provider Demographics
NPI:1104261130
Name:SATELLITE DIALYSIS OF SAN FRANCISCO LLC
Entity type:Organization
Organization Name:SATELLITE DIALYSIS OF SAN FRANCISCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:300 SANTANA ROW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2423
Mailing Address - Country:US
Mailing Address - Phone:415-653-5800
Mailing Address - Fax:650-625-6007
Practice Address - Street 1:1700 CALIFORNIA STREET
Practice Address - Street 2:SUITE 260
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4588
Practice Address - Country:US
Practice Address - Phone:415-653-5800
Practice Address - Fax:415-563-8023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SATELLITE HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-03
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550002753OtherSTATE OF CALIFORNIA
CA550002753OtherSTATE OF CALIFORNIA