Basic Information
| Provider Information | |||||||||
| NPI: | 1831480250 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALPHA VISTA SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1290 KIFER RD | ||||||||
| Address2: | STE 301 | ||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940865322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083312181 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1290 KIFER RD | ||||||||
| Address2: | STE 301 | ||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940865322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083312181 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2011 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | PRADEESH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHEIF EXCECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4083312181 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CEO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.