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NPI Code Detail

MEDICARE: MEK ARDEN, LLC

MEDICARE: MEK ARDEN, 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
1314000000XSkilled Nursing FacilityCA
2314000000XSkilled Nursing Facility100000009CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
205D0704663OTHERCACLIA ID NUMBER
34279830001OTHERCADME POS NUMBER

General Provider Information

NPI Number : 1275539454
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEK ARDEN, LLC
Provider Business Mailing Address
First Line : 1506 S. GLENDALE AVENUE
Second Line :
City : GLENDALE
State : CA
Zip : 91205
Country : US
Telephone Number : 818-247-6200
Fax Number : 818-247-6213
Provider Business Practice Location Address
First Line : 3400 ALTA ARDEN EXPY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-2103
Country : US
Telephone Number : 916-481-5500
Fax Number : 916-481-9845
Authorized Official
Title or Position : FINANCIAL CONTROLLER
Name : MR. FERNAN PEDRAJA
Credential :
Telephone Number : 818-247-6200
Provider Enumeration Date : 06/22/2005
Last Update Date : 04/26/2016

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