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NPI Code Detail

MEDICARE: SSC OAKLAND FRUITVALE OPERATING COMPANY LP

MEDICARE: SSC OAKLAND FRUITVALE OPERATING COMPANY LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility020000067CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275670895
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSC OAKLAND FRUITVALE OPERATING COMPANY LP
Provider Business Mailing Address
First Line : 5300 W SAM HOUSTON PKWY N
Second Line : SUITE 100
City : HOUSTON
State : TX
Zip : 77041-5161
Country : US
Telephone Number : 832-467-6000
Fax Number :
Provider Business Practice Location Address
First Line : 3020 E 15TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2305
Country : US
Telephone Number : 510-261-5613
Fax Number : 510-261-5940
Authorized Official
Title or Position : SR DIRECTOR AR
Name : KELLE C SANTORO
Credential :
Telephone Number : 832-467-5728
Provider Enumeration Date : 01/31/2007
Last Update Date : 04/09/2015

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Directions to “SSC OAKLAND FRUITVALE OPERATING COMPANY LP ” Practice Location

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