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General NPI Number Information
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NPI Number | 1174569743
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Entity Type | Organization
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Legal Business Name | PALMERO ENTERPRISES INC.
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 2530 SOLACE PL
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4309
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Country | US
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Telephone | 650-961-6161
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Fax | 650-967-7878
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Provider Business Mailing Address
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Address Line | 2530 SOLACE PLACE
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4309
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Country | US
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Telephone | 650-961-6161
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Fax | 650-967-7878
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Authorized Official
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Title or Position | OWNER
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Name | MR. SHANE MCCORMACK
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Credential |
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Telephone | 650-961-6161
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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 | 220000410
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License Number State | CA
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