Healthcare Provider Details

I. General information

NPI: 1417275959
Provider Name (Legal Business Name): WINDSOR HAYWARD ESTATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25919 GADING RD
HAYWARD CA
94544-2725
US

IV. Provider business mailing address

9200 W SUNSET BLVD SUITE 700
WEST HOLLYWOOD CA
90069-3502
US

V. Phone/Fax

Practice location:
  • Phone: 510-782-8424
  • Fax: 510-782-0199
Mailing address:
  • Phone: 310-860-2284
  • Fax: 310-595-3752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number020000039
License Number StateCA

VIII. Authorized Official

Name: ASH CHAWLA
Title or Position: VP FOR FINANCE
Credential:
Phone: 310-385-1078