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NPI Code Detail

MEDICARE: BLYTHE VENTURES, INC

MEDICARE: BLYTHE VENTURES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013904879
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLYTHE VENTURES, INC
Provider Business Mailing Address
First Line : 3232 E ARTESIA BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-2811
Country : US
Telephone Number : 562-422-9219
Fax Number :
Provider Business Practice Location Address
First Line : 3232 E ARTESIA BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-2811
Country : US
Telephone Number : 562-422-9219
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : JOHN BOWEN
Credential :
Telephone Number : 562-422-9219
Provider Enumeration Date : 10/05/2005
Last Update Date : 01/22/2008

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Directions to “BLYTHE VENTURES, INC ” Practice Location

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