Healthcare Provider Details

I. General information

NPI: 1639264914
Provider Name (Legal Business Name): CLEAR VIEW SANITARIUM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15823 S WESTERN AVE
GARDENA CA
90247-3703
US

IV. Provider business mailing address

15823 S WESTERN AVE
GARDENA CA
90247-3703
US

V. Phone/Fax

Practice location:
  • Phone: 310-538-2323
  • Fax: 310-538-3509
Mailing address:
  • Phone: 310-538-2323
  • Fax: 310-538-3509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000028
License Number StateCA

VIII. Authorized Official

Name: DR. MARK D TOWNS
Title or Position: ADMINISTRATOR
Credential: PH.D.
Phone: 310-538-2323