Provider Demographics
NPI:1366431074
Name:GAFFAR ENTERPRISES INC
Entity type:Organization
Organization Name:GAFFAR ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GAFFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:ADOMINSTRATOR
Authorized Official - Phone:510-834-9880
Mailing Address - Street 1:1901 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1853
Mailing Address - Country:US
Mailing Address - Phone:510-834-9880
Mailing Address - Fax:510-763-7367
Practice Address - Street 1:1901 3RD AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1853
Practice Address - Country:US
Practice Address - Phone:510-834-9880
Practice Address - Fax:510-763-7367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAZZR05543I314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
555774Medicare ID - Type Unspecified