Provider Demographics
NPI:1013327543
Name:CAMDEN POSTACUTE CARE, INC.
Entity type:Organization
Organization Name:CAMDEN POSTACUTE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANEESH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-349-7108
Mailing Address - Street 1:721 N EUCLID ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4116
Mailing Address - Country:US
Mailing Address - Phone:424-349-7108
Mailing Address - Fax:562-457-5584
Practice Address - Street 1:1331 CAMDEN AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-6701
Practice Address - Country:US
Practice Address - Phone:408-377-4030
Practice Address - Fax:562-457-5584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR184391Medicaid
CA555838Medicare Oscar/Certification