Healthcare Provider Details

I. General information

NPI: 1942389531
Provider Name (Legal Business Name): S&F MARKET STREET HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E MARKET ST
LONG BEACH CA
90805-5910
US

IV. Provider business mailing address

9200 WEST SUNSET BOULEVARD 700
WEST HOLLYWOOD CA
90069-3502
US

V. Phone/Fax

Practice location:
  • Phone: 562-428-4681
  • Fax: 562-428-8049
Mailing address:
  • Phone: 310-385-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number940000080
License Number StateCA

VIII. Authorized Official

Name: MR. ASH CHAWLA
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 310-385-1090