Provider Demographics
NPI:1932270352
Name:COMPREHENSIVE RENAL SERVICES, INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE RENAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-630-8611
Mailing Address - Street 1:6000 FAIRWAY DR
Mailing Address - Street 2:# 14
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-4244
Mailing Address - Country:US
Mailing Address - Phone:916-630-8611
Mailing Address - Fax:916-630-8665
Practice Address - Street 1:6000 FAIRWAY DR
Practice Address - Street 2:#14
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-4244
Practice Address - Country:US
Practice Address - Phone:916-630-8611
Practice Address - Fax:916-630-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACDC02765FMedicaid
CAZZZ48312ZOtherINDEPENDENT RENAL FACILIT
CAZZZ48312ZOtherINDEPENDENT RENAL FACILIT