Provider Demographics
NPI:1659495604
Name:SANHYD, INC.
Entity Type:Organization
Organization Name:SANHYD, INC.
Other - Org Name:JONES CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PRATAP
Authorized Official - Middle Name:
Authorized Official - Last Name:PODDATOORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-677-3566
Mailing Address - Street 1:524 CALLAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4610
Mailing Address - Country:US
Mailing Address - Phone:510-352-3402
Mailing Address - Fax:510-352-8530
Practice Address - Street 1:524 CALLAN AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4610
Practice Address - Country:US
Practice Address - Phone:510-352-3402
Practice Address - Fax:510-352-8530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANHYD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-16
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA020000051314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555842Medicare Oscar/Certification