Healthcare Provider Details

I. General information

NPI: 1922348960
Provider Name (Legal Business Name): WESTWOOD HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12121 SANTA MONICA BLVD
LOS ANGELES CA
90025-2515
US

IV. Provider business mailing address

12121 SANTA MONICA BLVD
LOS ANGELES CA
90025-2515
US

V. Phone/Fax

Practice location:
  • Phone: 310-826-0821
  • Fax: 310-826-2768
Mailing address:
  • Phone: 310-826-0821
  • Fax: 310-826-2768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000123
License Number StateCA

VIII. Authorized Official

Name: MR. STEPHEN REISSMAN
Title or Position: CEO
Credential:
Phone: 310-574-3733