Healthcare Provider Details

I. General information

NPI: 1578992780
Provider Name (Legal Business Name): APPLE CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11620 W WASHINGTON BLVD
LOS ANGELES CA
90066-5916
US

IV. Provider business mailing address

11620 W WASHINGTON BLVD
LOS ANGELES CA
90066-5916
US

V. Phone/Fax

Practice location:
  • Phone: 310-390-9045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number240000433
License Number StateCA

VIII. Authorized Official

Name: AARON MOAS
Title or Position: ADMINISTRATOR
Credential:
Phone: 951-685-7474