Healthcare Provider Details

I. General information

NPI: 1619347465
Provider Name (Legal Business Name): ALAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 LINCOLN PARK AVE
LOS ANGELES CA
90031-2920
US

IV. Provider business mailing address

28202 CABOT RD 412
LAGUNA NIGUEL CA
92677-1271
US

V. Phone/Fax

Practice location:
  • Phone: 323-276-5700
  • Fax: 323-276-5732
Mailing address:
  • Phone: 949-347-7100
  • 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: MR. JEFFREY BRADSHAW
Title or Position: MANAGER
Credential:
Phone: 949-347-7100