MEDICARE: BNCC, INC.

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
1	314000000X	Skilled Nursing Facility		CA

Other Identifiers

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

General Provider Information

NPI Number	:	1467450528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BNCC, INC.

Provider Business Mailing Address
First Line	:	4022 VIA DE LA PAZ
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92057-7335
Country	:	US
Telephone Number	:	760-533-6763
Fax Number	:	760-439-5423

Provider Business Practice Location Address
First Line	:	285 W CHANSLOR WAY
Second Line	:
City	:	BLYTHE
State	:	CA
Zip	:	92225-1246
Country	:	US
Telephone Number	:	760-922-8176
Fax Number	:	760-922-0789

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MS. SANDRA W BLESSING
Credential	:	RN
Telephone Number	:	760-533-6763

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	08/22/2020

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Directions to “BNCC, INC. ” Practice Location

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