Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ponca Dialysis LLC

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1538400239

Ponca Dialysis LLC is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Jose, California. Registered with an NPI since 2013.

In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1290 Tully Rd Ste 60
San Jose, CA 95122-3069
Phone: (408) 275-0105
Fax: (408) 275-0115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X

Record details

NPI number1538400239
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samuel Wey — Vp Licensure & Certification · (615) 341-6641
Other names Tully Road Home Training; Tully Road Home Training
NPI enumeratedMarch 6, 2013
Last updated in NPPESMarch 29, 2024
Certification dateMarch 29, 2024
Mailing address5200 Virginia Way, L&C Dept, Brentwood, TN 37027-7569

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