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General NPI Number Information
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NPI Number | 1083019657
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Entity Type | Organization
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Legal Business Name | PITTSBURG SKILLED NURSING GROUP, INC.
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 535 SCHOOL ST
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City | PITTSBURG
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State | CA
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Zip | 94565-3937
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Country | US
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Telephone | 925-432-3831
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1438
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City | ALAMEDA
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State | CA
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Zip | 94501-0155
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO / PRESIDENT
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Name | ALLEN LEUNG
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Credential | J.D.
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Telephone | 510-926-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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