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NPI Code Detail

MEDICARE: ALAL, LLC

MEDICARE: ALAL, 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 Facility

General Provider Information

NPI Number : 1619347465
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALAL, LLC
Provider Business Mailing Address
First Line : 28202 CABOT RD
Second Line : 412
City : LAGUNA NIGUEL
State : CA
Zip : 92677-1271
Country : US
Telephone Number : 949-347-7100
Fax Number :
Provider Business Practice Location Address
First Line : 2221 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2920
Country : US
Telephone Number : 323-276-5700
Fax Number : 323-276-5732
Authorized Official
Title or Position : MANAGER
Name : MR. JEFFREY BRADSHAW
Credential :
Telephone Number : 949-347-7100
Provider Enumeration Date : 10/05/2015
Last Update Date : 11/24/2015

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