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General NPI Number Information
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NPI Number | 1750945879
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Entity Type | Organization
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Legal Business Name | LA PALMA VILLA INC
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 1418 W LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-2818
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Country | US
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Telephone | 714-350-1052
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Fax | 714-841-0094
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Provider Business Mailing Address
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Address Line | 6952 RIO VISTA DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-6660
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Country | US
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Telephone | 714-350-1052
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Fax | 714-841-0094
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Authorized Official
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Title or Position | CEO
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Name | MR. ARVIN F BUMANGLAG
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Credential |
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Telephone | 714-350-1052
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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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