Organization
551 GIBSON AVE SNF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MARTIN (MANAGER)
(831) 657-5200
Entity
Organization
Contact information
Practice address
551 GIBSON AVE, PACIFIC GROVE, CA 93950-4330
(831) 657-5200
Mailing address
4747 VIEWRIDGE AVE STE 105, SAN DIEGO, CA 92123-1688
(619) 402-3044
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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