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General NPI Number Information
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NPI Number | 1942168596
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Entity Type | Organization
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Legal Business Name | 1919 CUTTING BLVD LLC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1919 CUTTING BLVD
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City | RICHMOND
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State | CA
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Zip | 94804-2662
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Country | US
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Telephone | 510-233-8513
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 HISTORIC DECATUR RD STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92106-6071
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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 | MANAGER
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Name | RICHARD MARTIN
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Credential |
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Telephone | 510-233-8513
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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 |
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