Portola Gardens LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

385600402 Issued in CA

Legal business name

PORTOLA GARDENS LLC

Practice address

350 University Street
San Francisco, CA 94143

Phone

(415) 337-1587

Fax

(415) 337-1573

NPI assigned

May 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark J. Cimino

Title

Licensee

Phone

(916) 704-6275

Specialties & licenses 1

Addresses

Tax ID family

Portola Gardens LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Portola Gardens LLC

  • Assisted Living Facility
  • San Francisco, CA
  • NPI 1215561444
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1053803502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 UNIVERSITY STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143",
            "telephone_number": "415-337-1587",
            "fax_number": "415-337-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 UNIVERSITY STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143",
            "telephone_number": "415-337-1587",
            "fax_number": "415-337-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTOLA GARDENS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "CIMINO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "916-704-6275",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "385600402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dharana Portillo
• Van David Portlock
• Bennett Dennis Portnoy
• Joshua R Porto
• Renata Porto
• Portola Gardens LLC
• Thomas A. Ports, M.D.
• Livier Portugal-Ramirez
• Olenka Portugal, DDS
• Sarah Jill Porzucki

• Assisted Living Facility in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.