Healthcare Provider Details

I. General information

NPI: 1700843216
Provider Name (Legal Business Name): AURORA LAS ENCINAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 E DEL MAR BLVD
PASADENA CA
91107-4375
US

IV. Provider business mailing address

2900 E DEL MAR BLVD
PASADENA CA
91107-4375
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-9901
  • Fax: 626-356-2503
Mailing address:
  • Phone: 626-795-9901
  • Fax: 626-356-2503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: HELEN EASLEY
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 626-795-9901