Fullerton Plaza Guest Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FULLERTON PLAZA GUEST HOME

Practice address

3931 Madonna Dr
Fullerton, CA 92835-1229

Phone

(657) 387-9603

NPI assigned

Nov 4, 2021

Organization subpart

No

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

Authorized official

Name

Sean Garlo Manguray

Title

Owner

Phone

(657) 387-9603

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1740945633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3931 MADONNA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351229",
            "telephone_number": "657-387-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 MADONNA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351229",
            "telephone_number": "657-387-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLERTON PLAZA GUEST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "MANGURAY",
        "authorized_official_first_name": "SEAN GARLO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "657-387-9603"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.