Healthcare Provider Details

I. General information

NPI: 1033821178
Provider Name (Legal Business Name): LOS ANGELES HEALTH AND REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14724 GLEDHILL ST
PANORAMA CITY CA
91402-1213
US

IV. Provider business mailing address

14724 GLEDHILL ST
PANORAMA CITY CA
91402-1213
US

V. Phone/Fax

Practice location:
  • Phone: 818-644-7505
  • Fax: 818-459-3800
Mailing address:
  • Phone: 818-644-7505
  • Fax: 818-459-3800

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: ELLA UNDZHYAN
Title or Position: CEO
Credential:
Phone: 818-644-7505