Healthcare Provider Details

I. General information

NPI: 1750427803
Provider Name (Legal Business Name): RUBINS BRIERWOOD TERRACE CONVALESCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 S LA CIENEGA BLVD
LOS ANGELES CA
90035-3715
US

IV. Provider business mailing address

1480 S LA CIENEGA BLVD
LOS ANGELES CA
90035-3715
US

V. Phone/Fax

Practice location:
  • Phone: 323-655-8390
  • Fax:
Mailing address:
  • Phone: 323-655-8390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number970000019
License Number StateCA

VIII. Authorized Official

Name: MR. MORRIS ZYSKIND
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-655-8390