NPIMap

Organization Active NPI

Petar Guest Homes, Inc.

  • Assisted Living Facility
  • Clayton, CA
National Provider Identifier
1588064232
Registry record updated Aug 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
071441200 Issued in CA
Legal business name
PETAR GUEST HOMES, INC.
Practice address
33 Petar CT
Clayton, CA 94517-1712
Phone
(925) 672-2841
NPI assigned
Aug 31, 2014
Organization subpart
Yes
Parent organization
PETAR GUEST HOMES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2014

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

Authorized official

Name
Gholam Reza Keyhantaj
Title
President
Phone
(925) 360-2936

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 071441200 CA Primary

Addresses

Primary practice location

33 Petar CT
Clayton, CA 94517-1712

Mailing address

33 Petar CT
Clayton, CA 94517-1712
Phone (925) 672-2841

Other names 1

  • Diablo Senior Homes Other name

National Provider Directory

National Provider Directory
Tax ID family
Petar Guest Homes Inc2 organizations share this tax ID, including this one
Part of
Petar Guest Homes Inc

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1409443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409443200000",
    "number": "1588064232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 PETAR CT",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945171712",
            "telephone_number": "925-672-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 PETAR CT",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945171712",
            "telephone_number": "925-672-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETAR GUEST HOMES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PETAR GUEST HOMES, INC.",
        "enumeration_date": "2014-08-31",
        "last_updated": "2014-08-31",
        "status": "A",
        "authorized_official_last_name": "KEYHANTAJ",
        "authorized_official_first_name": "GHOLAM",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-360-2936"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "071441200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diablo Senior Homes",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clayton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2014; 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.