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NPI Code Detail

MEDICARE: ROSENWALD C. ROBERTSON ADULT DAY HEALTH CARE

MEDICARE: ROSENWALD C. ROBERTSON ADULT DAY HEALTH CARE
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
1261QA0600XAdult Day Care Clinic/Center070000518CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ADU70075GOTHERCAMEDI-CAL

General Provider Information

NPI Number : 1548458235
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSENWALD C. ROBERTSON ADULT DAY HEALTH CARE
Provider Business Mailing Address
First Line : 3400 ELVAS AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95819-1913
Country : US
Telephone Number : 916-452-2529
Fax Number : 916-452-3129
Provider Business Practice Location Address
First Line : 3400 ELVAS AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95819-1913
Country : US
Telephone Number : 916-452-2529
Fax Number : 916-452-3129
Authorized Official
Title or Position : ADMINISTRATOR/PROGRAM DIRECTOR
Name : MR. JAMES P. MACDONALD
Credential : MSDT, DPI
Telephone Number : 916-452-2529
Provider Enumeration Date : 10/09/2007
Last Update Date : 10/09/2007

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