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NPI 1649163759

NPI 1649163759 : OCEANVIEW LIVING OF SAN PEDRO LLC : SAN PEDRO, CA

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General NPI Number Information
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    NPI Number           |    1649163759
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    Entity Type          |    Organization 
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    Legal Business Name  |    OCEANVIEW LIVING OF SAN PEDRO LLC 
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Dates
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    Enumeration Date     |    05/29/2025
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    Last Update Date     |    05/29/2025
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Provider Practice Location Address
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    Address Line         |    2100 S WESTERN AVE 
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    City                 |    SAN PEDRO
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    State                |    CA
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    Zip                  |    90732-4331
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    Country              |    US
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    Telephone            |    310-548-0625
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7162 BEVERLY BLVD STE 263 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90036-2547
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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                 |    MR. BARUCH  BERKOWITZ 
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    Credential           |    
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    Telephone            |    323-251-1426
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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       |    
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    License Number State |    
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