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General NPI Number Information
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NPI Number | 1144109927
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Entity Type | Organization
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Legal Business Name | GENTLE BREEZE MANOR LLC
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1142 CORONA LN
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City | COSTA MESA
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State | CA
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Zip | 92626-5525
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Country | US
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Telephone | 714-227-6557
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 IRVINE AVE STE 222
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-4602
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Country | US
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Telephone | 714-227-6557
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Fax |
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Authorized Official
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Title or Position | LICENSEE
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Name | RAMIL DELOS SANTOS
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Credential |
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Telephone | 714-227-6557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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