Healthcare Provider Details

I. General information

NPI: 1053004606
Provider Name (Legal Business Name): STUDEBAKER HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13226 STUDEBAKER RD
NORWALK CA
90650-2532
US

IV. Provider business mailing address

7162 BEVERLY BLVD # 565
LOS ANGELES CA
90036-2547
US

V. Phone/Fax

Practice location:
  • Phone: 562-868-0591
  • Fax:
Mailing address:
  • Phone: 610-457-9593
  • Fax:

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: MORDECHAI WERTHEIMER
Title or Position: VP OF FINANCE
Credential:
Phone: 610-457-9593