NPI Code Detail JSON Logo

1033098900 NPI number — SAN MARCOS SNF OPERATOR LLC

NPI Number: 1033098900
Health Care Provider/Practitioner: SAN MARCOS SNF OPERATOR LLC

Information about “1033098900” NPI (SAN MARCOS SNF OPERATOR LLC) exists in 1033098900 in HTML format HTML  |  1033098900 in plain Text format TXT  |  1033098900 in PDF (Portable Document Format) PDF  |  1033098900 in an XML format XML  formats.

NPI Number : 1033098900 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033098900",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SAN MARCOS SNF OPERATOR LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6300 WILSHIRE BLVD STE 1800",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90048-5236",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "323-651-1808",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1586 W SAN MARCOS BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN MARCOS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92078-4019",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "760-471-2986",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/27/2025",
    "LastUpdateDate": "08/27/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SMEDRA",
    "AuthorizedOfficialFirstName": "IRA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "323-651-1808",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "314000000X",
        "TaxonomyName": "Skilled Nursing Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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