Healthcare Provider Details

I. General information

NPI: 1710219308
Provider Name (Legal Business Name): SAN JOSE HEALTHCARE & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 N 13TH ST
SAN JOSE CA
95112-3439
US

IV. Provider business mailing address

75 N 13TH ST
SAN JOSE CA
95112-3439
US

V. Phone/Fax

Practice location:
  • Phone: 408-295-2665
  • Fax: 408-294-4990
Mailing address:
  • Phone: 408-295-2665
  • Fax: 408-294-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number070000053
License Number StateCA

VIII. Authorized Official

Name: MR. SOL MAJER
Title or Position: PRESIDENT
Credential:
Phone: 626-800-1191