Healthcare Provider Details

I. General information

NPI: 1114081056
Provider Name (Legal Business Name): DIGNITY COMMUNITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S GRAND AVE
LOS ANGELES CA
90015-3010
US

IV. Provider business mailing address

3215 PROSPECT PARK DR
RANCHO CORDOVA CA
95670-6017
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-5910
  • Fax: 213-765-4078
Mailing address:
  • Phone: 916-861-1102
  • Fax: 916-861-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number930000024
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number930000024
License Number StateCA

VIII. Authorized Official

Name: REBECCA CHENG
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 213-742-5898