Healthcare Provider Details

I. General information

NPI: 1184790065
Provider Name (Legal Business Name): INLAND MEDICAL ENTERPRISES DBA ALCOTT REHABILITATION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 W OLYMPIC BLVD
LOS ANGELES CA
90019-3504
US

IV. Provider business mailing address

3551 W OLYMPIC BLVD
LOS ANGELES CA
90019-3504
US

V. Phone/Fax

Practice location:
  • Phone: 323-737-2000
  • Fax: 323-734-3234
Mailing address:
  • Phone: 323-737-2000
  • Fax: 323-734-3234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number970000001
License Number StateCA

VIII. Authorized Official

Name: MR. MARTIN HIPSCHMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-737-2000