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NPI Code Detail

MEDICARE: GMPH CORPORATION

MEDICARE: GMPH CORPORATION
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 Facility

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 : 1710975396
Entity Type Code : Organization
Provider Name (Legal Business Name) : GMPH CORPORATION
Provider Business Mailing Address
First Line : 5400 FOUNTAIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-1007
Country : US
Telephone Number : 323-461-4301
Fax Number : 323-461-2784
Provider Business Practice Location Address
First Line : 5400 FOUNTAIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-1007
Country : US
Telephone Number : 323-461-4301
Fax Number : 323-461-2784
Authorized Official
Title or Position : PRESIDENT
Name : LYDIA FLORO CRUZ
Credential :
Telephone Number : 323-965-0600
Provider Enumeration Date : 10/08/2005
Last Update Date : 08/22/2020

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Directions to “GMPH CORPORATION ” Practice Location

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