| NPI | 1932193984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA MALDONADO Administrator 310-838-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 910000079) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2012-12-18 |