Healthcare Provider Details

I. General information

NPI: 1023537891
Provider Name (Legal Business Name): POINT ISABEL POST ACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 CARLSON BLVD
EL CERRITO CA
94530-3907
US

IV. Provider business mailing address

107 W LEMON AVE
MONROVIA CA
91016-2809
US

V. Phone/Fax

Practice location:
  • Phone: 510-525-3212
  • Fax: 510-724-9922
Mailing address:
  • Phone: 626-658-7344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number140000276
License Number StateCA

VIII. Authorized Official

Name: CRYSTAL SOLORZANO
Title or Position: MANAGER
Credential:
Phone: 626-658-7344