Provider Demographics
NPI:1821168402
Name:GUARDIAN ADULT HEALTH CENTERS OF CALIFORNIA
Entity Type:Organization
Organization Name:GUARDIAN ADULT HEALTH CENTERS OF CALIFORNIA
Other - Org Name:GUARDIAN ADULT DAY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:BEHR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:510-669-1007
Mailing Address - Street 1:3905 SAN PABLO DAM RD
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2823
Mailing Address - Country:US
Mailing Address - Phone:510-669-1005
Mailing Address - Fax:510-669-1008
Practice Address - Street 1:3905 SAN PABLO DAM RD
Practice Address - Street 2:
Practice Address - City:EL SOBRANTE
Practice Address - State:CA
Practice Address - Zip Code:94803-2823
Practice Address - Country:US
Practice Address - Phone:510-669-1005
Practice Address - Fax:510-669-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA70000511OtherSTATE ADHC LICENSE