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General NPI Number Information
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NPI Number | 1467847996
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Entity Type | Organization
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Legal Business Name | CEDAR OPERATIONS, LLC
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 11970 4TH STREET
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City | YUCALPA
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State | CA
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Zip | 92399-5396
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Country | US
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Telephone | 909-790-2273
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Fax | 909-797-2260
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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 | 909-790-2273
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Fax | 909-797-2260
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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 | 240000441
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License Number State | CA
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