Coordinated Care Center Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

9500092 Issued in CA

Legal business name

COORDINATED CARE CENTER INC.

Practice address

6812 Oak Ave
San Gabriel, CA 91775-2030

Phone

(626) 446-5263

Fax

(626) 446-8109

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Kevin Erwin Cablayan

Title

Director of Finance

Phone

(619) 521-9641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• San Marino Manor Doing business as

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881745487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6812 OAK AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752030",
            "telephone_number": "626-446-5263",
            "fax_number": "626-446-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 OAK AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752030",
            "telephone_number": "626-446-5263",
            "fax_number": "626-446-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COORDINATED CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CABLAYAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ERWIN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "619-521-9641"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "9500092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT18606G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Marino Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in San Gabriel, CA
• Providers in San Gabriel, 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 Aug 22, 2020; 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.