MEDICARE: SABRA WEST COAST OPERATIONS I, LLC

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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1124749924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SABRA WEST COAST OPERATIONS I, LLC

Provider Business Mailing Address
First Line	:	18500 VON KARMAN AVE STE 550
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92612-0539
Country	:	US
Telephone Number	:	949-679-0398
Fax Number	:	949-679-8868

Provider Business Practice Location Address
First Line	:	12742 MONTE VISTA RD
Second Line	:
City	:	POWAY
State	:	CA
Zip	:	92064-2524
Country	:	US
Telephone Number	:	858-673-1541
Fax Number	:

Authorized Official
Title or Position	:	SENIOR VP, TREASURER, SECRETARY
Name	:	JESSICA FLORES
Credential	:
Telephone Number	:	949-679-0398

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

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