RAI-HARBOR BLVD.-GARDEN GROVE
NPI 1891868519
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Garden Grove, CA

Q: What is RAI Care Centers Of Southern California I, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Active since November 17, 2006CLIA 05D1017096 · Waiver

12761 HARBOR BLVD, GARDEN GROVE, CA 92840(714) 539-3122(714) 539-3922 Get Directions Write a Review

NPPES record last updated: January 27, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Rai-harbor Blvd.-garden Grove NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAI-HARBOR BLVD.-GARDEN GROVE (NPI 1891868519) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Garden Grove, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through September 15, 2027 and lists Mark R. Fawcett, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1891868519

Entity TypeOrganization

Primary Taxonomy261QE0700X

Legal Business NameRAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC

Location Address12761 HARBOR BLVDGarden Grove, CA 92840-5800

Mailing Address12761 Harbor Blvd.Garden Grove, CA 92840-5800 · (714) 539-3122 · Fax (714) 539-3922

Phone(714) 539-3122

Fax(714) 539-3922

Organization SubpartYesParent: Fresenius Medical Care Holdings, Inc.

Authorized OfficialMark R. FawcettTreasurer · (781) 699-9000

Enumeration DateNovember 17, 2006

Last NPPES UpdateJanuary 27, 2016

✔ NPI 1891868519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities

Taxonomy Code261QE0700X

12761 HARBOR BLVD, Garden Grove, CA 92840

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Other Names 1

Other NameRai-harbor Blvd.-garden Grove

Other Identifiers 5

Other=========-05CA · Kaiser

OtherZZZR0210ZCA · Blue Shield Of California

Medicare ID-Type Unspecified552527CA

MedicaidCDC52527GCA

Other552527CA · Blue Cross Of California

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1017096

Rai Care Centers Of Southern California I, LLC (rai-Harbor Boulevard-Garden Grove) · Garden Grove, CA

Active · expires Sep 15, 2027

CLIA Number05D1017096

Laboratory TypeEnd Stage Renal Disease Dialysis Facility

Certificate Effective DateSeptember 16, 2025

Certificate Expiration DateSeptember 15, 2027

Laboratory DirectorHong Kim

Laboratory Phone(714) 539-3122

Laboratory LocationRai Care Centers Of Southern California I, LLC (rai-Harbor Boulevard-Garden Grove)12761 Harbor Blvd Ste I-3, Garden Grove, CA 92840

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRESENIUS MEDICAL CARE ORANGE COUNTY, LLC

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)

12761 HARBOR BLVD
GARDEN GROVE, CA 92840

Orange County (714) 539-3122

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is RAI Care Centers Of Southern California I, LLC's NPI number?

The NPI number for RAI Care Centers Of Southern California I, LLC is 1891868519. It was assigned to this organization in the NPPES registry on November 17, 2006. The provider is also known as RAI-Harbor Blvd.-Garden Grove.

Where is RAI Care Centers Of Southern California I, LLC located?

RAI Care Centers Of Southern California I, LLC is located at 12761 Harbor Blvd, Garden Grove, CA 92840. The listed phone number is (714) 539-3122.

What is RAI Care Centers Of Southern California I, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does RAI Care Centers Of Southern California I, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1017096) is associated with this NPI, valid through September 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for RAI Care Centers Of Southern California I, LLC was last updated on January 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.