# CHA HOLLYWOOD MEDICAL CENTER LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Holyywood Presbyterian Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336164151
- **Authorized official:** MR. KENNETH I RIVERS (PRESIDENT, CEO)
- **Authorized official phone:** (323) 913-4914

## Contact information

- **Practice address:** 4636 FOUNTAIN AVE, LOS ANGELES, CA 90029-1830
- **Practice address phone:** (323) 913-4830
- **Practice address fax:** (323) 913-4552
- **Mailing address:** 1300 N VERMONT AVE, LOS ANGELES, CA 90027-6005
- **Mailing address phone:** (213) 413-3000
- **Mailing address fax:** (323) 660-0446

## Taxonomy

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

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 04/17/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC70045G | — | CA |
| 05 | — | ZZT06311G | — | CA |