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General NPI Number Information
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NPI Number | 1699770867
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Entity Type | Organization
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Legal Business Name | MARINA GARDEN NURSING CENTER, INC.
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 08/28/2009
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Provider Practice Location Address
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Address Line | 3201 FERNSIDE BLVD
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City | ALAMEDA
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State | CA
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Zip | 94501-1709
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Country | US
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Telephone | 510-523-2363
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Fax | 510-865-5076
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Provider Business Mailing Address
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Address Line | 3201 FERNSIDE BLVD
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City | ALAMEDA
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State | CA
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Zip | 94501-1709
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Country | US
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Telephone | 510-536-1838
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Fax | 510-536-1816
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. BELINDA LEUNG
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Credential | RN, CRRN, MBA
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Telephone | 510-536-1838
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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 | 206013653
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License Number State | CA
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