Healthcare Provider Details

I. General information

NPI: 1841903697
Provider Name (Legal Business Name): UNIVERSITY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2022
Last Update Date: 12/26/2022
Certification Date: 12/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E ADAMS BLVD
LOS ANGELES CA
90011-1426
US

IV. Provider business mailing address

230 E ADAMS BLVD
LOS ANGELES CA
90011-1426
US

V. Phone/Fax

Practice location:
  • Phone: 213-948-0193
  • Fax: 213-748-3299
Mailing address:
  • Phone: 213-948-0193
  • Fax: 213-748-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: EZEQUIEL BERCOVICH
Title or Position: MANAGER
Credential:
Phone: 213-948-0193