Provider Demographics
NPI:1528466331
Name:USRC TORRANCE HOME PROGRAM, LLC
Entity type:Organization
Organization Name:USRC TORRANCE HOME PROGRAM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP/GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2732
Mailing Address - Street 1:5851 LEGACY CIR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5966
Mailing Address - Country:US
Mailing Address - Phone:214-736-2732
Mailing Address - Fax:
Practice Address - Street 1:23441 MADISON ST
Practice Address - Street 2:SUITE 320
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4725
Practice Address - Country:US
Practice Address - Phone:310-375-7173
Practice Address - Fax:310-378-8756
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. RENAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-10
Last Update Date:2022-06-29
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
CA552784Medicare Oscar/Certification