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NPI Code Detail

MEDICARE: A.K. BEAN FOUNDATION

MEDICARE: A.K. BEAN FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number : 1154781276
Entity Type Code : Organization
Provider Name (Legal Business Name) : A.K. BEAN FOUNDATION
Provider Business Mailing Address
First Line : 623 GREAT JONES ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6005
Country : US
Telephone Number : 707-429-8888
Fax Number : 707-429-1908
Provider Business Practice Location Address
First Line : 623 GREAT JONES ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6005
Country : US
Telephone Number : 707-429-8888
Fax Number : 707-429-1908
Authorized Official
Title or Position : BILLING MANAGER
Name : MRS. JUDY ANNE LOPEZ
Credential :
Telephone Number : 707-664-7798
Provider Enumeration Date : 03/02/2016
Last Update Date : 09/21/2022

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