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General NPI Number Information
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NPI Number | 1174926448
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Entity Type | Organization
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Legal Business Name | PARKWAY OPERATIONS, LLC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 7760 PARKWAY DR
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City | LA MESA
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State | CA
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Zip | 91942-2028
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Country | US
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Telephone | 619-469-0124
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Fax | 619-469-6401
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Provider Business Mailing Address
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Address Line | 114 PACIFICA SUITE 230
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City | IRVINE
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State | CA
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Zip | 92618
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Country | US
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Telephone | 619-463-0124
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Fax | 619-469-6401
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | LELEAND BRUCE
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Credential |
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Telephone | 949-220-2000
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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 | 080000053
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License Number State | CA
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