Healthcare Provider Details

I. General information

NPI: 1730266883
Provider Name (Legal Business Name): AJIT HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 SOUTH WESTLAKE AVENUE
LOS ANGELES CA
90057
US

IV. Provider business mailing address

316 SOUTH WESTLAKE AVENUE
LOS ANGELES CA
90057
US

V. Phone/Fax

Practice location:
  • Phone: 213-484-0510
  • Fax: 213-484-5931
Mailing address:
  • Phone: 213-484-0510
  • Fax: 213-484-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number970000073
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number056242
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberZZT06242I
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: ELIZABETH P AUSTRIA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 323-333-0509