Healthcare Provider Details

I. General information

NPI: 1205654373
Provider Name (Legal Business Name): TONOPAH CARE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2024
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13130 TONOPAH ST
ARLETA CA
91331-4944
US

IV. Provider business mailing address

13130 TONOPAH ST
ARLETA CA
91331-4944
US

V. Phone/Fax

Practice location:
  • Phone: 323-831-7629
  • Fax: 818-233-0972
Mailing address:
  • Phone: 323-831-7629
  • Fax: 818-233-0972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: NARINE DARBINYAN
Title or Position: CEO
Credential:
Phone: 818-445-5276