Healthcare Provider Details

I. General information

NPI: 1760680490
Provider Name (Legal Business Name): GARDENA FLORES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14165 PURCHE AVE
GARDENA CA
90249-2824
US

IV. Provider business mailing address

14165 PURCHE AVE
GARDENA CA
90249-2824
US

V. Phone/Fax

Practice location:
  • Phone: 310-323-4570
  • Fax:
Mailing address:
  • Phone: 310-323-4570
  • Fax:

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: LAIB GREENSPOON
Title or Position: ADMINISTRATOR
Credential:
Phone: 310-323-4570