| Organization Name: | GENESIS HEALTHCARE SYSTEM |
| NPI Number: | 1104150580 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONNIE FINCH (OFFICE MANAGER) |
| Mailing Address: | 11760 Central Ave Ste 125 Chino |
| State: | CA US |
| Postal Code: | 917101909 |
| Phone Number: | 9095025588 |
| Fax Number: | 9099021013 |
| NPI Enumeration Date: | 10/01/2009 |
| NPI Last Update Date: | 10/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 34087 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |