MEDICARE: GATEWAY HOME HEALTH CORP.

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
1	251E00000X	Home Health Agency	C3875187	CA

General Provider Information

NPI Number	:	1861846693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY HOME HEALTH CORP.

Provider Business Mailing Address
First Line	:	10 CROW CANYON CT STE 210
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1980
Country	:	US
Telephone Number	:	925-322-4455
Fax Number	:	888-816-0197

Provider Business Practice Location Address
First Line	:	10 CROW CANYON CT STE 210
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1980
Country	:	US
Telephone Number	:	925-322-4455
Fax Number	:	888-816-0197

Authorized Official
Title or Position	:	CFO / ADMINISTRATOR
Name	:	MR. FREDERICK S KEHRET
Credential	:
Telephone Number	:	925-322-4455

Provider Enumeration Date	:	04/18/2016
Last Update Date	:	12/27/2022

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Directions to “GATEWAY HOME HEALTH CORP. ” Practice Location

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