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NPI Code Detail

MEDICARE: DIYAVILLA, INC

MEDICARE: DIYAVILLA, 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
1314000000XSkilled Nursing Facility220000050CA

General Provider Information

NPI Number : 1477970416
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIYAVILLA, INC
Provider Business Mailing Address
First Line : 540 W MONTE VISTA AVE
Second Line :
City : VACAVILLE
State : CA
Zip : 95688-3620
Country : US
Telephone Number : 707-449-3400
Fax Number : 707-450-0954
Provider Business Practice Location Address
First Line : 33 MATEO AVE
Second Line :
City : MILLBRAE
State : CA
Zip : 94030-2037
Country : US
Telephone Number : 650-689-5784
Fax Number : 510-991-0071
Authorized Official
Title or Position : VP.OPERATIONS
Name : TRILOCHAN SINGH
Credential :
Telephone Number : 510-468-1909
Provider Enumeration Date : 03/27/2014
Last Update Date : 03/27/2014

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Directions to “DIYAVILLA, INC ” Practice Location

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