Healthcare Provider Details

I. General information

NPI: 1376043372
Provider Name (Legal Business Name): THE GARDENS OF EL MONTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5044 BUFFINGTON RD
EL MONTE CA
91732-1466
US

IV. Provider business mailing address

4115 E BROADWAY
LONG BEACH CA
90803-1532
US

V. Phone/Fax

Practice location:
  • Phone: 626-443-1351
  • Fax:
Mailing address:
  • Phone: 562-930-0777
  • Fax: 562-344-4771

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: MRS. JANET MANDELBAUM
Title or Position: OWNER
Credential:
Phone: 562-843-4843