Healthcare Provider Details

I. General information

NPI: 1083019657
Provider Name (Legal Business Name): PITTSBURG SKILLED NURSING GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SCHOOL ST
PITTSBURG CA
94565-3937
US

IV. Provider business mailing address

PO BOX 1438
ALAMEDA CA
94501-0155
US

V. Phone/Fax

Practice location:
  • Phone: 925-432-3831
  • Fax:
Mailing address:
  • Phone:
  • 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: ALLEN LEUNG
Title or Position: CEO / PRESIDENT
Credential: J.D.
Phone: 510-926-8288