Provider Demographics
NPI:1356415509
Name:RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC
Entity type:Organization
Organization Name:RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:1800 HAIGHT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2712
Mailing Address - Country:US
Mailing Address - Phone:415-752-9886
Mailing Address - Fax:415-752-1133
Practice Address - Street 1:1800 HAIGHT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2712
Practice Address - Country:US
Practice Address - Phone:415-752-9886
Practice Address - Fax:415-752-1133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2021-08-14
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
CA052507OtherBLUE CROSS OF CALIFORNIA
CAZZR02507HMedicaid
CAZZZR0204ZOtherBLUE SHIELD OF CALIFORNIA
CA06OtherKAISER
CA06OtherKAISER