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General NPI Number Information
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NPI Number | 1831919190
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Entity Type | Organization
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Legal Business Name | PNP ESTATE LLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 5430 SIERRA VISTA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92505-3114
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Country | US
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Telephone | 213-316-6962
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Fax |
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Provider Business Mailing Address
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Address Line | 12495 LIMONITE AVE STE 1042
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City | EASTVALE
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State | CA
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Zip | 91752-2457
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Country | US
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Telephone | 213-316-6962
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | PHUONG PHAT
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Credential |
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Telephone | 213-316-6962
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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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