Portola Gardens LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PORTOLA GARDENS LLC

Practice address

350 University Street
San Francisco, CA 94134

Phone

(415) 337-1587

Fax

(415) 337-1573

NPI assigned

Feb 26, 2020

Organization subpart

No

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

Authorized official

Name

Mark J Cimino

Title

Licensee

Phone

(916) 486-9639

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 1053803502
  NPD tax ID

Locations

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1215561444",
    "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": "94134",
            "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": "94134",
            "telephone_number": "415-337-1587",
            "fax_number": "415-337-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTOLA GARDENS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "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": "916-486-9639"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van David Portlock
• Bennett Dennis Portnoy
• Joshua R Porto
• Renata Porto
• Portola Gardens LLC
• Portola MGMT BSD 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 Feb 26, 2020; 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.