Healthcare Provider Details

I. General information

NPI: 1255697405
Provider Name (Legal Business Name): PANORAMA MEADOWS NURSING CENTER, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14857 ROSCOE BLVD
PANORAMA CITY CA
91402
US

IV. Provider business mailing address

1141 S BEVERLY DR 3RD FLOOR
LOS ANGELES CA
90035-1119
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-5707
  • Fax:
Mailing address:
  • Phone: 310-286-3074
  • 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: MR. JACOB GRAFF
Title or Position: PARTNER
Credential:
Phone: 310-286-3074