MEDICARE: VISTA DEL SOL LTC, INC.

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	910000037	CA

General Provider Information

NPI Number	:	1932587946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISTA DEL SOL LTC, INC.

Provider Business Mailing Address
First Line	:	11620 W WASHINGTON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5916
Country	:	US
Telephone Number	:	310-390-9045
Fax Number	:	310-391-8738

Provider Business Practice Location Address
First Line	:	11620 W WASHINGTON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5916
Country	:	US
Telephone Number	:	310-390-9045
Fax Number	:	310-391-8738

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOV EDWARD JACOBS
Credential	:
Telephone Number	:	310-390-9045

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	05/28/2026

Similar Medicare Providers

1447443023 — VISTA DEL SOL HEALTH SERVICES INC
Practice Location Address:

11620 W WASHINGTON BLVD
LOS ANGELES, CA
90066-5916

Practice Phone: 310-390-9045
Practice Fax:

1578992780 — APPLE CARE CENTER LLC
Practice Location Address:

11620 W WASHINGTON BLVD
LOS ANGELES, CA
90066-5916

Practice Phone: 310-390-9045
Practice Fax:

1548650369 — MBJ THERAPY, LLC
Practice Location Address:

11620 W WASHINGTON BLVD
LOS ANGELES, CA
90066-5916

Practice Phone: 781-864-8252
Practice Fax:

1104208727 — VISTA DEL SOL HEALTH SERVICES INC
Practice Location Address:

11620 W WASHINGTON BLVD
LOS ANGELES, CA
90066-5916

Practice Phone: 310-390-9045
Practice Fax: 310-391-7677

1821470444 — VISTA DEL SOL HEALTH SERVICES INC
Practice Location Address:

11600 W WASHINGTON BLVD
CULVER CITY, CA
90066-5916

Practice Phone: 310-390-9045
Practice Fax: 310-391-7677

1154842524 — ALTO PHARMACY, LLC
Practice Location Address:

5916 BOWCROFT ST
LOS ANGELES, CA
90016-4302

Practice Phone: 800-874-5881
Practice Fax: 415-484-7058

Directions to “VISTA DEL SOL LTC, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.