MEDICARE: B&E CONVALESCENT CENTER, 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	910000136	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	:	1346225059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&E CONVALESCENT CENTER, INC

Provider Business Mailing Address
First Line	:	14819 S VERMONT AVE
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3002
Country	:	US
Telephone Number	:	310-532-9460
Fax Number	:	310-532-0083

Provider Business Practice Location Address
First Line	:	14819 S VERMONT AVE
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3002
Country	:	US
Telephone Number	:	310-532-9460
Fax Number	:	310-532-0083

Authorized Official
Title or Position	:	ASSOCIATE DIRECTOR OF PT ACCOUNTING
Name	:	MS. TAMMY MORA
Credential	:
Telephone Number	:	562-576-1284

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	06/04/2026

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