Healthcare Provider Details

I. General information

NPI: 1568766848
Provider Name (Legal Business Name): PALMCREST CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2010
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 CEDAR AVE
LONG BEACH CA
90807-3809
US

IV. Provider business mailing address

3501 CEDAR AVE
LONG BEACH CA
90807-3809
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-1731
  • Fax: 562-988-3531
Mailing address:
  • Phone: 562-595-1731
  • Fax: 562-988-3531

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: MR. MATTHEW S KARP
Title or Position: MANAGER
Credential:
Phone: 818-821-3897