Healthcare Provider Details

I. General information

NPI: 1518036060
Provider Name (Legal Business Name): BURBANK HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 S MAIN ST
BURBANK CA
91506-3205
US

IV. Provider business mailing address

4032 WILSHIRE BLVD FL 6
LOS ANGELES CA
90010-3425
US

V. Phone/Fax

Practice location:
  • Phone: 818-843-2330
  • Fax: 818-843-8082
Mailing address:
  • Phone: 213-389-6900
  • Fax: 818-843-8082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number920000008
License Number StateCA

VIII. Authorized Official

Name: IRA DAVID FRIEDMAN
Title or Position: MANAGER
Credential:
Phone: 213-389-6900