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NPI Code Detail

MEDICARE: MARLINDA IMPERIAL, LLC

MEDICARE: MARLINDA IMPERIAL, 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 : 1548332117
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARLINDA IMPERIAL, LLC
Provider Business Mailing Address
First Line : 150 BELLEFONTAINE ST
Second Line :
City : PASADENA
State : CA
Zip : 91105-3102
Country : US
Telephone Number : 626-796-1103
Fax Number :
Provider Business Practice Location Address
First Line : 150 BELLEFONTAINE ST
Second Line :
City : PASADENA
State : CA
Zip : 91105-3102
Country : US
Telephone Number : 626-796-1103
Fax Number :
Authorized Official
Title or Position : CFO
Name : LINDA GASSOUMIS
Credential :
Telephone Number : 310-638-6691
Provider Enumeration Date : 11/15/2006
Last Update Date : 08/22/2020

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Directions to “MARLINDA IMPERIAL, LLC ” Practice Location

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