# EISENHOWER NURSING & CONVALESCENT HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619979754
- **Authorized official:** MR. DAVID H BERGER (PRESIDENT)
- **Authorized official phone:** (626) 798-9133

## Contact information

- **Practice address:** 1470 N FAIR OAKS AVE, PASADENA, CA 91103-1801
- **Practice address phone:** (626) 798-9133
- **Practice address fax:** (626) 798-7704
- **Mailing address:** 1470 N FAIR OAKS AVE, PASADENA, CA 91103-1801
- **Mailing address phone:** (626) 798-9133
- **Mailing address fax:** (626) 798-7704

## Taxonomy

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

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05617J | — | CA |