MPB Senior Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MPB SENIOR CARE LLC

Practice address

17583 Sultana St
Hesperia, CA 92345-6594

Phone

(213) 434-1262

NPI assigned

Oct 5, 2020

Organization subpart

No

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

Authorized official

Name

Kyle Y Watanabe

Title

Director

Phone

(213) 326-9208

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1467059287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N ROSE DR STE 431",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928707513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17583 SULTANA ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456594",
            "telephone_number": "213-434-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPB SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "213-326-9208"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Hesperia, CA
• Providers in Hesperia, 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 Oct 5, 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.