# KAISER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255616280
- **Authorized official:** MS. TABASSUM MUNIR RD (CLINICAL DIETITIAN)
- **Authorized official phone:** (510) 481-6319

## Contact information

- **Practice address:** 1440 168TH AVE, SAN LEANDRO, CA 94578-2409
- **Practice address phone:** (510) 481-6319
- **Mailing address:** 1440 168TH AVE, SAN LEANDRO, CA 94578-2409
- **Mailing address phone:** (510) 481-6319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 943494 | CA | Yes |

## Other

- **Enumeration date:** 10/21/2011
- **Last updated:** 10/21/2011