institution
Ponca Dialysis Llc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Jose, California
NPI 1538400239

Ponca Dialysis Llc is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Brentwood, CA and is specialized in End-Stage Renal Disease (ESRD) Treatment. Ponca Dialysis Llc practices in San Jose, CA. The NPI Number for Ponca Dialysis Llc is 1538400239 and holds a License No. (California).

The current practice location address for Ponca Dialysis Llc is 1290 Tully Rd, San Jose, CA and can be reached out via phone at 408-275-0105 and via fax at 408-275-0115.

Location: 1290 Tully Rd, San Jose, CA, 37027-7569
institution
Provider Profile Details
NPI Number
1538400239
Provider Name
Ponca Dialysis Llc
Credential
Provider Entity Type
Organization
Address
1290 Tully Rd, San Jose, CA, 37027-7569
Phone Number
408-275-0105
Fax Number
408-275-0115
Provider Enumeration Date
03/06/2013
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1538400239 05 CA
institution
Provider Business Practice Location Address Details
Address
1290 Tully Rd
City
State
Zip
95122-3069
Phone Number
408-275-0105
Fax Number
408-275-0115
person
Provider Business Mailing Address Details
Address
1290 Tully Rd
City
State
Zip
95122-3069
Phone Number
408-275-0105
Fax Number
408-275-0115
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
License No.
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Definition
Definition to come...
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