MEDICARE: ASLB, 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1588358220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASLB, LLC

Provider Business Mailing Address
First Line	:	28202 CABOT RD STE 412
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1271
Country	:	US
Telephone Number	:	949-347-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	3747 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3428
Country	:	US
Telephone Number	:	562-426-6123
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	JARED KIRKWOOD
Credential	:
Telephone Number	:	949-347-7100

Provider Enumeration Date	:	06/06/2023
Last Update Date	:	06/06/2023

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