Healthcare Provider Details

I. General information

NPI: 1568818367
Provider Name (Legal Business Name): VISTA DEL SOL POSTACUTE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 RICHLAND AVE
CERES CA
95307-4509
US

IV. Provider business mailing address

721 N EUCLID ST STE 200
ANAHEIM CA
92801-4116
US

V. Phone/Fax

Practice location:
  • Phone: 209-537-4581
  • Fax: 562-457-5584
Mailing address:
  • Phone: 424-349-7108
  • Fax: 562-457-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MANEESH A BANSAL
Title or Position: CEO
Credential:
Phone: 424-349-7108