Cccma

Organization Active NPI Long Term Care Hospital · Millbrae, CA

NPI 1174955587 · NPPES record last updated Aug 7, 2013

Key facts

NPI
1174955587
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Hospital 282E00000X
License
22677 (CA)
Legal business name
CCCMA
Practice address
1149 Fernwood Dr
Millbrae, CA 94030-1011
Phone
(650) 302-5864
NPI assigned
Aug 7, 2013
Organization subpart
No

Authorized official

Name
Ash Jain
Title
Ceo
Phone
(510) 796-0222

Corporate family (same tax ID) 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
California Cardiovascular Consultants Medical Associates Cor (2 organizations share this tax ID)

Locations

27206 Calaroga Ave
Hayward, CA 94545
Phone (510) 670-1111

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 22677 CA Yes
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X 22677 CA

Addresses

Primary practice location

1149 Fernwood Dr
Millbrae, CA 94030-1011

Mailing address

27206 Calaroga Ave
Hayward, CA 94545-4300

Other providers in Millbrae, CA

All providers in Millbrae, CA · Long Term Care Hospital in California

Sources for this page

Verify at the official NPI Registry.