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NPI Code Detail

MEDICARE: GRANCARE LLC

MEDICARE: GRANCARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023080660
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANCARE LLC
Provider Business Mailing Address
First Line : 3032 ROWENA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-2005
Country : US
Telephone Number : 323-665-1185
Fax Number :
Provider Business Practice Location Address
First Line : 3032 ROWENA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-2005
Country : US
Telephone Number : 323-665-1185
Fax Number :
Authorized Official
Title or Position : REGIONAL FINANCIAL ANALYST
Name : MRS. ANDREA SAAVEDRA
Credential :
Telephone Number : 707-208-1940
Provider Enumeration Date : 02/07/2006
Last Update Date : 08/22/2020

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Directions to “GRANCARE LLC ” Practice Location

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