# MCCLURE CONVALESCENT HOSPITAL AND REHABILITATION CENTER, INC.

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

## Provider details

- **NPI number:** 1922090091
- **Authorized official:** JAMES PREIMESBERGER (PRESIDENT)
- **Authorized official phone:** (925) 855-0881

## Contact information

- **Practice address:** 2910 MCCLURE ST, OAKLAND, CA 94609-3505
- **Practice address phone:** (510) 836-3677
- **Practice address fax:** (510) 836-1938
- **Mailing address:** 5000 EXECUTIVE PKWY, SUITE 150, SAN RAMON, CA 94583-4210
- **Mailing address phone:** (925) 855-0881
- **Mailing address fax:** (925) 855-9297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 020000064 | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 020000064 | CA | — |
| 332BN1400X | Nursing Facility Supplies (DME) | 020000064 | CA | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 020000064 | CA | — |

## Other

- **Enumeration date:** 08/16/2005
- **Last updated:** 02/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR55067G | — | CA |