Healthcare Provider Details

I. General information

NPI: 1689053274
Provider Name (Legal Business Name): NORTHGATE POSTACUTE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 PROFESSIONAL CENTER PARKWAY
SAN RAFAEL CA
94903-2703
US

IV. Provider business mailing address

721 N EUCLID ST STE 200
ANAHEIM CA
92801-4116
US

V. Phone/Fax

Practice location:
  • Phone: 415-479-1230
  • Fax: 562-457-5584
Mailing address:
  • Phone: 424-349-7108
  • Fax: 562-457-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number010000374
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. MANEESH BANSAL
Title or Position: CEO
Credential: M.D.
Phone: 424-349-7108