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General NPI Number Information
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NPI Number | 1629042833
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Entity Type | Organization
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Legal Business Name | CALIFORNIA-NEVADA METHODIST HOMES
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 1850 ALICE ST
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City | OAKLAND
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State | CA
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Zip | 94612-4175
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Country | US
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Telephone | 510-835-5511
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Fax | 510-273-0529
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Provider Business Mailing Address
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Address Line | 201 19TH ST SUITE 100
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City | OAKLAND
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State | CA
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Zip | 94612-4117
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Country | US
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Telephone | 510-893-8989
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Fax | 510-893-3041
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. ROBERT E HUBBARD
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Credential |
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Telephone | 510-893-8989
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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 | 020000057
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License Number State | CA
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