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Organization
1450 NORTH FAIR OAKS LLC
Active
Organization
1450 NORTH FAIR OAKS LLC
Active
Other names
Golden Cross Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEMAR MERCADO (MANAGING MEMBER)
(626) 305-0281
Entity
Organization
Contact information
Practice address
1450 N FAIR OAKS AVE, PASADENA, CA 91103-1801
(626) 791-1948
(626) 791-9282
Mailing address
1450 N FAIR OAKS AVE, PASADENA, CA 91103-1801
(626) 791-1948
(626) 791-9282
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000082
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55096H
—
CA
Enumeration date
12/17/2010
Last updated
12/17/2010
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