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General NPI Number Information
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NPI Number | 1851195150
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Entity Type | Organization
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Legal Business Name | PNB BELL LAKE LLC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 12400 DAKOTA RIVER CT
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City | EASTVALE
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State | CA
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Zip | 91752-4310
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Country | US
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Telephone | 951-444-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 158 SPECKLED ALDER
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City | IRVINE
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State | CA
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Zip | 92618-1168
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PAUL PINERO
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Credential |
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Telephone | 562-716-5409
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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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