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General NPI Number Information
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NPI Number | 1881681088
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Entity Type | Organization
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Legal Business Name | SAN BERNARDINO CARE COMPANY
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 467 E GILBERT ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-5318
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Country | US
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Telephone | 909-884-4781
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Fax |
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Provider Business Mailing Address
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Address Line | 1937 PONTIUS AVE
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City | LOS ANGELES
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State | CA
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Zip | 90025-5611
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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 | OWNER
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Name | SOL BERRIENTOS
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Credential |
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Telephone | 909-884-4781
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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 |
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License Number State | CA
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