Basic Information
| Provider Information | |||||||||
| NPI: | 1609892579 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RENAL CARE ASSOCIATES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2121 N BEVERLY AVE | ||||||||
| Address2: | STE 105 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203276265 | ||||||||
| FaxNumber: | 5203279300 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 N BEVERLY AVE | ||||||||
| Address2: | STE 105 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203276265 | ||||||||
| FaxNumber: | 5203279300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 06/21/2010 | ||||||||
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| AuthorizedOfficialLastName: | LUI | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5203276265 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.