Marina Vista Post Acute LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

140000139 Issued in CA

Legal business name

MARINA VISTA POST ACUTE LLC

Practice address

1919 Cutting Blvd
Richmond, CA 94804-2662

Phone

(510) 233-8513

Fax

(510) 227-1831

NPI assigned

Jun 21, 2017

Organization subpart

No

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

Authorized official

Name

Crystal Solorzano

Title

Managing Member

Phone

(626) 346-0300

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1467972430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W LEMON AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162809",
            "telephone_number": "626-346-0300",
            "fax_number": "626-737-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 CUTTING BLVD",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948042662",
            "telephone_number": "510-233-8513",
            "fax_number": "510-227-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA VISTA POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "SOLORZANO",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "626-346-0300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "140000139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05292J",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OSCAR/CERTIFICATION",
            "identifier": "055292",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Richmond, CA
• Providers in Richmond, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.