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General NPI Number Information
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NPI Number | 1851460240
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Entity Type | Organization
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Legal Business Name | PARK ANAHEIM HEALTH CARE, LLC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 3435 W BALL RD
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City | ANAHEIM
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State | CA
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Zip | 92804-3708
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Country | US
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Telephone | 714-827-5880
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Fax | 714-827-8815
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Provider Business Mailing Address
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Address Line | 4032 WILSHIRE BLVD FL 6
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City | LOS ANGELES
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State | CA
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Zip | 90010-3425
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Country | US
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Telephone | 213-389-6900
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Fax | 213-368-8560
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DAVID FRIEDMAN
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Credential |
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Telephone | 213-389-6900
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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 | 060000094
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License Number State | CA
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