Provider Demographics
NPI:1376926931
Name:VISTA DEL SOL POSTACUTE CARE
Entity Type:Organization
Organization Name:VISTA DEL SOL POSTACUTE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MANEESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-349-7108
Mailing Address - Street 1:812 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380
Mailing Address - Country:US
Mailing Address - Phone:209-667-2828
Mailing Address - Fax:209-667-4683
Practice Address - Street 1:812 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4645
Practice Address - Country:US
Practice Address - Phone:209-667-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055475Medicare Oscar/Certification