Provider Demographics
NPI:1528759198
Name:POSADA MEDICAL REALTY GROUP, LLC
Entity type:Organization
Organization Name:POSADA MEDICAL REALTY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBOTKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-591-3383
Mailing Address - Street 1:322 POSADA LN STE B
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-4021
Mailing Address - Country:US
Mailing Address - Phone:805-591-3383
Mailing Address - Fax:
Practice Address - Street 1:322 POSADA LN STE B
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4021
Practice Address - Country:US
Practice Address - Phone:805-591-3383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies