Organization
MARINA VISTA POST ACUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL SOLORZANO (MANAGING MEMBER)
(626) 346-0300
Entity
Organization
Contact information
Practice address
1919 CUTTING BLVD, RICHMOND, CA 94804-2662
(510) 233-8513
(510) 227-1831
Mailing address
107 W LEMON AVE, MONROVIA, CA 91016-2809
(626) 346-0300
(626) 737-7260
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
140000139
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055292
MEDICARE OSCAR/CERTIFICATION
CA
05
—
ZZR05292J
—
CA
Enumeration date
06/21/2017
Last updated
06/21/2017
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