MEDICARE: PLEASANT CARE CORPORATION

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	:	1861419780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT CARE CORPORATION

Provider Business Mailing Address
First Line	:	2258 FOOTHILL BLVD STE 6
Second Line	:
City	:	LA CANADA
State	:	CA
Zip	:	91011-1476
Country	:	US
Telephone Number	:	818-248-9808
Fax Number	:	818-541-7072

Provider Business Practice Location Address
First Line	:	1565 HILL RD
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94947-4063
Country	:	US
Telephone Number	:	415-897-6161
Fax Number	:	415-898-0561

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	JOSEPH PADRE
Credential	:
Telephone Number	:	818-248-9808

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	08/22/2020

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Directions to “PLEASANT CARE CORPORATION ” Practice Location

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