Healthcare Provider Details

I. General information

NPI: 1518954122
Provider Name (Legal Business Name): PACIFIC CARE NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 12/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 PACIFIC PL
LONG BEACH CA
90806-1239
US

IV. Provider business mailing address

3355 PACIFIC PL
LONG BEACH CA
90806-1239
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-4336
  • Fax: 562-424-6499
Mailing address:
  • Phone: 562-595-4336
  • Fax: 562-424-6499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number940000129
License Number StateCA

VIII. Authorized Official

Name: ROSALIE PIACENTI SANCHEZ
Title or Position: MANAGER
Credential:
Phone: 562-930-0777