Healthcare Provider Details

I. General information

NPI: 1700874393
Provider Name (Legal Business Name): CAMTRENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 W BADILLO ST
COVINA CA
91722-3763
US

IV. Provider business mailing address

519 W BADILLO ST
COVINA CA
91722-3763
US

V. Phone/Fax

Practice location:
  • Phone: 626-915-5621
  • Fax: 626-966-3680
Mailing address:
  • Phone: 626-915-5621
  • Fax: 626-966-3680

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: LYDIA FLORO CRUZ
Title or Position: PRESIDENT
Credential:
Phone: 323-965-0600