Live Oak Manor, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

230000199 Issued in CA

Legal business name

LIVE OAK MANOR, INC.

Practice address

9000 Larkin Rd
Live Oak, CA 95953-9599

Phone

(530) 695-8020

Fax

(530) 695-1843

NPI assigned

Jul 19, 2005

Last updated

Jun 10, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

HORIZON WEST HEALTHCARE OF CALIFORNIA, INC.As reported in NPPES

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

Authorized official

Name

Larry E Bear

Title

Chief Executive Officer

Phone

(916) 624-6230

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1700885019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SIERRA COLLEGE BLVD",
            "address_2": "SUITE 190",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773906",
            "telephone_number": "916-624-6230",
            "fax_number": "916-624-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 LARKIN RD",
            "city": "LIVE OAK",
            "state": "CA",
            "postal_code": "959539599",
            "telephone_number": "530-695-8020",
            "fax_number": "530-695-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK MANOR, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HORIZON WEST HEALTHCARE OF CALIFORNIA, INC.",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "BEAR",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "916-624-6230"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55535H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Snehaben Joshi, DPT
• Amina Khan
• Faiza Khan
• Uqsam Khan
• John W Kramer, MD
• Live Oak Unified School District
• Morelia Marquez
• Mundh NP & Garretson MD Medical Corporation (Feather River Health Solutions)
• Camille L Mundh, FNP-C
• Hardeep Mundh

• Skilled Nursing Facility in Live Oak, CA
• Providers in Live Oak, 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 10, 2008; 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.