Healthcare Provider Details

I. General information

NPI: 1205299484
Provider Name (Legal Business Name): LA BREA REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N LA BREA AVE
LOS ANGELES CA
90036-2015
US

IV. Provider business mailing address

990 E DEL MAR BLVD
PASADENA CA
91106-3252
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-6152
  • Fax:
Mailing address:
  • Phone:
  • 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: STEVEN BERGER
Title or Position: MANAGER
Credential:
Phone: 626-793-6152