Healthcare Provider Details

I. General information

NPI: 1710977780
Provider Name (Legal Business Name): THE REHABILITATION CENTRE OF BEVERLY HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 S SAN VICENTE BLVD
LOS ANGELES CA
90048-4621
US

IV. Provider business mailing address

580 S SAN VICENTE BLVD
LOS ANGELES CA
90048-4621
US

V. Phone/Fax

Practice location:
  • Phone: 323-782-1500
  • Fax: 323-782-1510
Mailing address:
  • Phone: 323-782-1500
  • Fax: 323-782-1510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000142
License Number StateCA

VIII. Authorized Official

Name: MR. ELDON J TEPER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 323-782-1500