Organization
DIVERSIFIED SUSTAINABLE SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SHIRLEY M.D. (OWNER)
(916) 435-2963
Entity
Organization
Contact information
Practice address
3031 STANFORD RANCH RD, SUITE 2, #220, ROCKLIN, CA 95765-5554
(916) 435-2963
(916) 435-2964
Mailing address
3031 STANFORD RANCH RD, SUITE 2, #220, ROCKLIN, CA 95765-5554
(916) 435-2963
(916) 435-2964
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
G66004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G66004
—
CA
Enumeration date
08/15/2006
Last updated
08/22/2020
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