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NPI Code Detail

MEDICARE: SUNBRIDGE HALLMARK HEALTH SERVICES LLC

MEDICARE: SUNBRIDGE HALLMARK HEALTH SERVICES LLC
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 Facility060000121CA

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 : 1730136482
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNBRIDGE HALLMARK HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 101 SUN AVE NE
Second Line : COMPLIANCE DEPARTMENT
City : ALBUQUERQUE
State : NM
Zip : 87109-4373
Country : US
Telephone Number : 505-468-5604
Fax Number : 505-468-4681
Provider Business Practice Location Address
First Line : 2210 EAST 1ST STREET
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3802
Country : US
Telephone Number : 714-547-7091
Fax Number : 714-547-4516
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : MICHAEL BERG
Credential :
Telephone Number : 505-468-4742
Provider Enumeration Date : 05/28/2006
Last Update Date : 07/13/2015

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Directions to “SUNBRIDGE HALLMARK HEALTH SERVICES LLC ” Practice Location

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