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General NPI Number Information
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NPI Number | 1245141530
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Entity Type | Organization
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Legal Business Name | EAST BAY LONGEVITY ASSISTED LIVING LLC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 388 12TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-4249
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Country | US
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Telephone | 510-808-7783
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Fax | 510-255-6089
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Provider Business Mailing Address
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Address Line | 1086 CLEARFIELD DR
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City | MILLBRAE
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State | CA
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Zip | 94030-2153
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Country | US
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Telephone | 415-218-2620
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ALICE KUANG
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Credential |
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Telephone | 415-218-2620
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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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