Healthcare Provider Details

I. General information

NPI: 1821168402
Provider Name (Legal Business Name): GUARDIAN ADULT HEALTH CENTERS OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 SAN PABLO DAM RD
EL SOBRANTE CA
94803-2823
US

IV. Provider business mailing address

3905 SAN PABLO DAM RD
EL SOBRANTE CA
94803-2823
US

V. Phone/Fax

Practice location:
  • Phone: 510-669-1005
  • Fax: 510-669-1008
Mailing address:
  • Phone: 510-669-1005
  • Fax: 510-669-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER H. BEHR JR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 510-669-1007