Organization
INSTITUTE ON AGING - SOUTHERN CALIFORNIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROXANA R BLADES (CHIEF FINANCIAL AND ADMIN OFFICER)
(415) 750-4101
Entity
Organization
Contact information
Practice address
3200 E GUASTI RD STE 173, ONTARIO, CA 91761-8660
(415) 823-6215
Mailing address
3575 GEARY BLVD, SAN FRANCISCO, CA 94118-3212
(415) 750-4111
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114132941
—
CA
05
—
1285906164
—
CA
05
—
1316445414
—
CA
05
—
1497964647
—
CA
05
—
1629251772
—
CA
05
—
1942418884
—
CA
Enumeration date
01/24/2018
Last updated
11/03/2023
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