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General NPI Number Information
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NPI Number | 1245608058
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Entity Type | Organization
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Legal Business Name | WESTMINSTER VILLA
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 13881 DAWSON ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-3166
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Country | US
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Telephone | 714-612-9309
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 S GARFIELD AVE
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City | ALHAMBRA
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State | CA
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Zip | 91801-4772
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Country | US
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Telephone | 714-612-9309
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTOR NGUYEN LE
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Credential |
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Telephone | 714-612-9309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 306004795
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License Number State | CA
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