# SAN GABRIEL CONVALESCENT CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** San Gabriel Convalescent Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215011556
- **Authorized official:** IRA DAVID FRIEDMAN (MANAGER)
- **Authorized official phone:** (213) 389-6900

## Contact information

- **Practice address:** 8035 HILL DR, ROSEMEAD, CA 91770-4116
- **Practice address phone:** (626) 280-4820
- **Practice address fax:** (626) 280-0227
- **Mailing address:** 4032 WILSHIRE BLVD 6FL, LOS ANGELES, CA 90010-3425
- **Mailing address phone:** (213) 389-6900
- **Mailing address fax:** (626) 280-0227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 950000091 | CA | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 09/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC05181H | — | CA |