Provider Demographics
NPI:1003992496
Name:B VON ARNIM INC
Entity Type:Organization
Organization Name:B VON ARNIM INC
Other - Org Name:NIGHTINGALE NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-357-4222
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-0066
Mailing Address - Country:US
Mailing Address - Phone:510-357-4222
Mailing Address - Fax:510-614-4306
Practice Address - Street 1:101 CALLAN AVE STE 405
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4523
Practice Address - Country:US
Practice Address - Phone:510-357-4222
Practice Address - Fax:510-614-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA020000358251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA-57296FMedicaid
CAHHA-57296FMedicaid