Healthcare Provider Details

I. General information

NPI: 1063328045
Provider Name (Legal Business Name): SAHARA RESIDENTIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E CENTER ST
MANTECA CA
95336-4719
US

IV. Provider business mailing address

2721 MAGAZINE LN
TRACY CA
95377-8544
US

V. Phone/Fax

Practice location:
  • Phone: 209-372-7900
  • Fax: 209-375-4736
Mailing address:
  • Phone: 209-612-8194
  • Fax:

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: SAIFUDDIN RANIWALA
Title or Position: MANAGER
Credential: PHARM D
Phone: 209-612-8194