MEDICARE: WESTERN HEALTHCARE MANAGEMENT

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
1	314000000X	Skilled Nursing Facility	240000122	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	240000122	OTHER	CA	STATE LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396718300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN HEALTHCARE MANAGEMENT

Provider Business Mailing Address
First Line	:	PO BOX 3000
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-9000
Country	:	US
Telephone Number	:	909-796-2595
Fax Number	:	909-796-8797

Provider Business Practice Location Address
First Line	:	1700 E WASHINGTON ST
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-4619
Country	:	US
Telephone Number	:	909-824-1530
Fax Number	:	909-825-9013

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	JAMES B. KILIAN
Credential	:
Telephone Number	:	909-796-2595

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	11/30/2016

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