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NPI Code Detail

MEDICARE: 1440 SOUTH EUCLID ST LLC

MEDICARE: 1440 SOUTH EUCLID ST 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 FacilityCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740275486
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1440 SOUTH EUCLID ST LLC
Provider Business Mailing Address
First Line : 1440 S EUCLID ST
Second Line :
City : ANAHEIM
State : CA
Zip : 92802-2156
Country : US
Telephone Number : 714-535-7264
Fax Number : 714-535-0940
Provider Business Practice Location Address
First Line : 1440 S EUCLID ST
Second Line :
City : ANAHEIM
State : CA
Zip : 92802-2156
Country : US
Telephone Number : 714-535-7264
Fax Number : 714-535-0940
Authorized Official
Title or Position : DIRECTOR OF PATIENT ACCOUNTING
Name : CAROLINE L BOYER
Credential :
Telephone Number : 818-367-9546
Provider Enumeration Date : 09/19/2005
Last Update Date : 08/22/2020

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Directions to “1440 SOUTH EUCLID ST LLC ” Practice Location

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