Healthcare Provider Details

I. General information

NPI: 1265804397
Provider Name (Legal Business Name): EASTLAND SUBACUTE AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 08/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 DURFEE AVE
EL MONTE CA
91732-2505
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 626-444-2535
  • Fax:
Mailing address:
  • Phone: 213-389-6900
  • Fax: 213-368-8560

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: DAVID FRIEDMAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 213-389-6900