MEDICARE: MONTROSE HEALTHCARE 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
1	314000000X	Skilled Nursing Facility	920000049	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1194897363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTROSE HEALTHCARE INC

Provider Business Mailing Address
First Line	:	4032 WILSHIRE BLVD FL 6
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3425
Country	:	US
Telephone Number	:	213-389-6900
Fax Number	:	213-368-8560

Provider Business Practice Location Address
First Line	:	2123 VERDUGO BLVD
Second Line	:	MONTROSE HEALTHCARE CENTER
City	:	MONTROSE
State	:	CA
Zip	:	91020-1628
Country	:	US
Telephone Number	:	818-249-3925
Fax Number	:	818-249-8832

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID FRIEDMAN
Credential	:
Telephone Number	:	213-389-6900

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/10/2017

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Directions to “MONTROSE HEALTHCARE INC ” Practice Location

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