Provider Demographics
NPI:1710099510
Name:BIO-MEDICAL APPLICATIONS OF CALIFORNIA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF CALIFORNIA, INC.
Other - Org Name:FMC DIALYSIS SERVICES RANCHO CUCAMONGA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:10532 ACACIA ST STE B2B3
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5446
Mailing Address - Country:US
Mailing Address - Phone:909-987-8887
Mailing Address - Fax:909-987-7866
Practice Address - Street 1:10532 ACACIA ST STE B2B3
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5446
Practice Address - Country:US
Practice Address - Phone:909-987-8887
Practice Address - Fax:909-987-7866
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2023-10-14
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
052855Medicare ID - Type Unspecified