Organization
COORDINATED CARE CENTER INC.
Active
Other names
San Marino Manor
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ERWIN CABLAYAN (DIRECTOR OF FINANCE)
(619) 521-9641
Entity
Organization
Contact information
Practice address
6812 OAK AVE, SAN GABRIEL, CA 91775-2030
(626) 446-5263
(626) 446-8109
Mailing address
6812 OAK AVE, SAN GABRIEL, CA 91775-2030
(626) 446-5263
(626) 446-8109
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
9500092
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18606G
—
CA
Enumeration date
01/12/2007
Last updated
08/22/2020
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