MEDICARE: CALIFORNIA FRIENDS HOMES

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	060000159	CA

General Provider Information

NPI Number	:	1568461341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA FRIENDS HOMES

Provider Business Mailing Address
First Line	:	12151 DALE STREET
Second Line	:
City	:	STANTON
State	:	CA
Zip	:	90680-3889
Country	:	US
Telephone Number	:	714-530-9100
Fax Number	:	714-530-0945

Provider Business Practice Location Address
First Line	:	12151 DALE STREET
Second Line	:
City	:	STANTON
State	:	CA
Zip	:	90680-3889
Country	:	US
Telephone Number	:	714-530-9100
Fax Number	:	714-530-0945

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. RANDAL J BROWN
Credential	:
Telephone Number	:	714-530-9100

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	10/17/2022

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