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General NPI Number Information
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NPI Number | 1366431074
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Entity Type | Organization
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Legal Business Name | GAFFAR ENTERPRISES INC
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1901 3RD AVE
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City | OAKLAND
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State | CA
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Zip | 94606-1853
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Country | US
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Telephone | 510-834-9880
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Fax | 510-763-7367
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Provider Business Mailing Address
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Address Line | 1901 3RD AVE
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City | OAKLAND
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State | CA
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Zip | 94606-1853
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Country | US
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Telephone | 510-834-9880
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Fax | 510-763-7367
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MR. GAFFAR SYED
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Credential | ADOMINSTRATOR
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Telephone | 510-834-9880
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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 | ZZR05543I
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License Number State | CA
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