Organization
MILLS-PENINSULA HEALTH SERVICES
Active
Other names
Mills Peninsula Extended Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN TRENT HUNTER (VP SHARED SERVICES)
(916) 297-8555
Entity
Organization
Contact information
Practice address
101 SO SAN MATEO DR, SAN MATEO, CA 94401-3805
(650) 696-5400
(696) 652-3052
Mailing address
PO BOX 742738, LOS ANGELES, CA 90074-2738
(650) 696-5400
(696) 652-3052
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
555482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55482F
—
CA
Enumeration date
06/15/2006
Last updated
02/27/2014
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