San Brunoidence Opco, LLC
NPI #1205213105 in San Bruno, California
Provider Information
- NPI Number
- 1205213105
- Entity Type
- Organization
- Organization Name
- San Brunoidence Opco, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Apr 29, 2015
- Last Updated
- Aug 20, 2024
Practice Location
- Address
- 890 EL CAMINO REAL
- City
- San Bruno
- State
- California
- ZIP Code
- 94066-3137
- Phone
- (650) 583-7768
Authorized Official
- Name
- JOHN MITCHELL
- Title
- SECRETARY
- Phone
- (385) 988-3319
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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