David Bostanchyan

Individual provider Active NPI Assisted Living Facility · Orangevale, CA

NPI 1043817638 · NPPES record last updated Oct 15, 2022

Key facts

NPI
1043817638
Entity type
Individual (NPI type 1)
Primary specialty
Assisted Living Facility 310400000X
License
342700545 (CA)
Practice address
8874 Nimbus Way
Orangevale, CA 95662-4522
Phone
(916) 627-0305
Fax
(916) 618-4587
NPI assigned
Oct 6, 2020
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
342700545CAMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Senior Care LLC Assisted Living Facility Current
since Feb 12, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 342700545 CA Yes

Addresses

Primary practice location

8874 Nimbus Way
Orangevale, CA 95662-4522

Mailing address

8874 Nimbus Way
Orangevale, CA 95662-4522
Phone (916) 627-0305

Other providers in Orangevale, CA

All providers in Orangevale, CA · Assisted Living Facility in California

Sources for this page

Verify at the official NPI Registry.