MEDICARE: MONTEREY PALMS OPERATING COMPANY, LP

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	250000340	CA

General Provider Information

NPI Number	:	1326336009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEREY PALMS OPERATING COMPANY, LP

Provider Business Mailing Address
First Line	:	44610 MONTEREY AVE
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3326
Country	:	US
Telephone Number	:	760-776-7700
Fax Number	:	760-776-1390

Provider Business Practice Location Address
First Line	:	44610 MONTEREY AVE
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3326
Country	:	US
Telephone Number	:	760-776-7700
Fax Number	:	760-776-1390

Authorized Official
Title or Position	:	REGIONAL FINANCIAL ANALYST
Name	:	MRS. ANDREA SAAVEDRA
Credential	:
Telephone Number	:	707-208-1940

Provider Enumeration Date	:	07/15/2011
Last Update Date	:	10/22/2014

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