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General NPI Number Information
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NPI Number | 1063013035
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Entity Type | Organization
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Legal Business Name | SO CAL POST ACUTE HOLDINGS LLC
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 7931 SORENSEN AVE
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City | WHITTIER
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State | CA
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Zip | 90606-2418
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Country | US
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Telephone | 562-698-0451
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Fax |
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Provider Business Mailing Address
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Address Line | 4747 VIEWRIDGE AVE STE 105
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City | SAN DIEGO
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State | CA
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Zip | 92123-1688
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RICHARD MARTIN
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Credential |
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Telephone | 562-698-0451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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