3555 Ceasar Chavez
Organization Active NPI Skilled Nursing Facility · San Francisco, CA
NPI 1740309103 · NPPES record last updated Jan 20, 2022
Key facts
- NPI
- 1740309103
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 220000070 (CA)
- Legal business name
- 3555 CEASAR CHAVEZ
- Practice address
- 3555 Cesar Chavez
San Francisco, CA 94110-4403 - Phone
- (415) 647-8600
- NPI assigned
- Mar 28, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael P. Holdsworth
- Title
- Vice President of Admin Cfo
- Phone
- (415) 600-3959
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Psychiatrist Clinic of
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 220000070 | CA | Yes |
Addresses
Primary practice location
3555 Cesar Chavez
San Francisco, CA 94110-4403
Mailing address
3555 Cesar Chavez
San Francisco, CA 94110-4403
Phone (415) 647-8600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC70042F | Medicaid | CA |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.