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General NPI Number Information
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NPI Number | 1740489459
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Entity Type | Organization
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Legal Business Name | SOUTH PASADENA CONVALESCENT INC.
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 904 MISSION ST
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City | S PASADENA
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State | CA
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Zip | 91030-3144
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Country | US
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Telephone | 626-799-9571
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Fax |
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Provider Business Mailing Address
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Address Line | 904 MISSION ST
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City | S PASADENA
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State | CA
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Zip | 91030-3144
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Country | US
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Telephone | 626-799-9571
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GUY REGGEV
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Credential |
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Telephone | 626-799-9571
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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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