Petra Dialysis LLC
Petra Dialysis LLC is a healthcare organization registered as End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Indio, CA, holding Type 2 (organization) NPI 1710439187 since 2016. The authorized official on file is Samuel Wey, Vp Licensure & Certification.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1710439187 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Petra Dialysis LLC |
| Other name | <Unavail> |
| Practice address | 82900 AVENUE 42, STE E, Indio, CA, 92203 |
| Phone | 7603426842 |
| Fax | 7603426807 |
| Enumeration date | 2016-11-01 |
| Last updated in NPPES | 2024-05-10 |
Authorized official
| Name | Samuel Wey |
|---|---|
| Title | Vp Licensure & Certification |
| Phone | 6153416641 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QE0700X | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710439187 | Medicaid | CA | — |
Copy-ready billing details
Provider: Petra Dialysis LLC NPI: 1710439187 Taxonomy: 261QE0700X (End-Stage Renal Disease (ESRD) Treatment Clinic/Center) Address: 82900 AVENUE 42, STE E, Indio, CA, 92203
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1336429059 | James Swarzkopf | Individual | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | Indio, CA |
| 1346522208 | Celestial Abriz | Individual | Pharmacist | Indio, CA |
| 1649680992 | Yan Li | Individual | Pharmacist | Indio, CA |
| 1629551056 | John-Luc Le Coze | Individual | Pharmacist | Indio, CA |
| 1356971717 | My Nguyen | Individual | Pharmacist | Indio, CA |
| 1295346203 | Twain Pham | Individual | Pharmacist | Indio, CA |
| 1669083499 | Marjan Sharifi | Individual | Pharmacist | Indio, CA |
| 1376322735 | Melanne Solis | Individual | Pharmacist | Indio, CA |
Verify this record
Cross-check NPI 1710439187 against the authoritative CMS record: view Petra Dialysis LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Petra Dialysis LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-05-10.