Organization
PREMIERCARE SKILLED NURSING SERVICES
Active
Other names
PremierCare Skilled Nursing Services
Organization subpart
No
Provider details
NPI number
Authorized official
SUNIL PATEL MD (OWNER / MD)
(209) 883-0525
Entity
Organization
Contact information
Practice address
1470 BESSIE AVE, TRACY, CA 95376-3417
(209) 883-0525
Mailing address
1470 BESSIE AVE, TRACY, CA 95376-3417
(209) 883-0525
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A4397
CA LICENSE
CA
Enumeration date
06/10/2020
Last updated
06/10/2020
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