Organization
SAN BRUNOIDENCE OPCO, LLC
Active
Other names
San Bruno Skilled Nursing
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
890 EL CAMINO REAL, SAN BRUNO, CA 94066-3137
(650) 583-7768
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Enumeration date
04/29/2015
Last updated
08/20/2024
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