# FOUNTAIN GARDENS CONVALESCENT HOSPITAL

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

## Provider details

- **NPI number:** 1649262957
- **Authorized official:** MR. JACK MARKOVITZ (OWNER)
- **Authorized official phone:** (562) 761-7365

## Contact information

- **Practice address:** 2222 SO SANTA ANA BLVD, LOS ANGELES, CA 90059
- **Practice address phone:** (323) 564-4461
- **Practice address fax:** (323) 569-9565
- **Mailing address:** 2222 SO SANTA ANA BLVD, LOS ANGELES, CA 90059
- **Mailing address phone:** (323) 564-4461
- **Mailing address fax:** (323) 569-9565

## Taxonomy

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

## Other

- **Enumeration date:** 08/22/2005
- **Last updated:** 01/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT18416G | — | CA |