Healthcare Provider Details

I. General information

NPI: 1649787268
Provider Name (Legal Business Name): BANCROFT HEALTH GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 BANCROFT AVE
SAN LEANDRO CA
94577-5105
US

IV. Provider business mailing address

182 HOWARD ST # 334
SAN FRANCISCO CA
94105-1611
US

V. Phone/Fax

Practice location:
  • Phone: 510-483-1680
  • Fax:
Mailing address:
  • Phone: 510-536-1838
  • 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: BELINDA LEUNG
Title or Position: CEO
Credential: RN, NHA, MBA
Phone: 510-536-1838