Active NPI
Baywood Court Skilled Nursing Facility
- Skilled Nursing Facility
- Castro Valley, CA
National Provider Identifier
1699720862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 140000030
- Legal business name
- BAYWOOD COURT SKILLED NURSING FACILITY
- Practice address
- 20103 Lake Chabot Rd
Castro Valley, CA 94546-5341 - Phone
- (510) 727-8290
- Fax
- (510) 582-1730
- NPI assigned
- May 24, 2006
- Organization subpart
- Yes
- Parent organization
- EDEN MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. George Derbedrosian
- Title
- Regional Director - PFS
- Phone
- (510) 869-6163
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 140000030 | CA | Primary |
Addresses
Primary practice location
20103 Lake Chabot Rd
Castro Valley, CA 94546-5341
Mailing address
3012 Summit St
Oakland, CA 94609-3480
Phone (510) 869-6591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC55454G | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Eden Medical Centersan Leandro Hospital Campus
- Part of
- Eden Medical Centersan Leandro Hospital Campus
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rehabilitation Hospital Unit
- San Leandro, CA
- NPI 1679523633
-
- General Acute Care Hospital
- Castro Valley, CA
- NPI 1265680045
-
- Rehabilitation Hospital Unit
- Castro Valley, CA
- NPI 1447297171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1284336000000",
"number": "1699720862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3012 SUMMIT ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093480",
"telephone_number": "510-869-6591",
"fax_number": "510-869-6592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20103 LAKE CHABOT RD",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945465341",
"telephone_number": "510-727-8290",
"fax_number": "510-582-1730"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAYWOOD COURT SKILLED NURSING FACILITY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EDEN MEDICAL CENTER",
"enumeration_date": "2006-05-24",
"last_updated": "2010-09-13",
"status": "A",
"authorized_official_last_name": "DERBEDROSIAN",
"authorized_official_first_name": "GEORGE",
"authorized_official_title_or_position": "REGIONAL DIRECTOR - PFS",
"authorized_official_telephone_number": "510-869-6163",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "140000030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55454G",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.