MEDICARE: PALMCREST CARE CENTER, 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1568766848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMCREST CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	3501 CEDAR AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3809
Country	:	US
Telephone Number	:	562-595-1731
Fax Number	:	562-988-3531

Provider Business Practice Location Address
First Line	:	3501 CEDAR AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3809
Country	:	US
Telephone Number	:	562-595-1731
Fax Number	:	562-988-3531

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MATTHEW S KARP
Credential	:
Telephone Number	:	818-821-3897

Provider Enumeration Date	:	12/31/2010
Last Update Date	:	12/05/2013

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