MEDICARE: EMBER CARE HEALTH CARE CENTER

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		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	:	1932180783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBER CARE HEALTH CARE CENTER

Provider Business Mailing Address
First Line	:	1550 N PARK AVE
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91768
Country	:	US
Telephone Number	:	909-623-0791
Fax Number	:	909-620-4891

Provider Business Practice Location Address
First Line	:	1550 N PARK AVE
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91768
Country	:	US
Telephone Number	:	909-623-0791
Fax Number	:	909-620-4891

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JEFFREY S KIRSCHNER
Credential	:	MPH
Telephone Number	:	909-623-0791

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	08/22/2020

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Directions to “EMBER CARE HEALTH CARE CENTER ” Practice Location

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