Healthcare Provider Details

I. General information

NPI: 1972642387
Provider Name (Legal Business Name): MCARLSON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 WILLOW ST
ALAMEDA CA
94501-5711
US

IV. Provider business mailing address

625 WILLOW ST
ALAMEDA CA
94501-5711
US

V. Phone/Fax

Practice location:
  • Phone: 510-523-3772
  • Fax: 510-523-9629
Mailing address:
  • Phone: 510-523-3772
  • Fax: 510-523-9629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0200001
License Number StateCA

VIII. Authorized Official

Name: ZENAIDA CABATO ROSETE
Title or Position: DIRECT OWNER
Credential: R.N.
Phone: 510-523-3772