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General NPI Number Information
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NPI Number | 1124998026
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Entity Type | Organization
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Legal Business Name | SAN BERNARDINO SENIOR CARE
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 17057 FOOTHILL BLVD STE 101
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City | FONTANA
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State | CA
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Zip | 92335-3523
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Country | US
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Telephone | 626-888-9580
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Fax |
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Provider Business Mailing Address
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Address Line | 713 W DUARTE RD # G810
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City | ARCADIA
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State | CA
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Zip | 91007-7564
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Country | US
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Telephone | 626-888-9580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YANAN LIANG
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Credential |
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Telephone | 626-888-9580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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