California-Nevada Methodist Homes

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

020000057 Issued in CA

Legal business name

CALIFORNIA-NEVADA METHODIST HOMES

Doing business as

Lake Park Retirement Residence

Practice address

1850 Alice St
Oakland, CA 94612-4175

Phone

(510) 835-5511

Fax

(510) 273-0529

NPI assigned

Feb 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert E Hubbard

Title

President and Ceo

Phone

(510) 893-8989

Specialties & licenses 1

Addresses

Other names 1

• Lake Park Retirement Residence Doing business as

Locations

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1629042833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 19TH ST",
            "address_2": "SUITE 100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946124117",
            "telephone_number": "510-893-8989",
            "fax_number": "510-893-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 ALICE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946124175",
            "telephone_number": "510-835-5511",
            "fax_number": "510-273-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA-NEVADA METHODIST HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "510-893-8989",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "020000057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Park Retirement Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Oakland, CA
• Providers in Oakland, 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 Apr 24, 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.