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Organization
CASA BONITA CONVALESCENT HOSPITAL LLC
Active
Organization
CASA BONITA CONVALESCENT HOSPITAL LLC
Active
Other names
Casa Bonita Convalescent Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
IRA DAVID FRIEDMAN (MANAGER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
535 E BONITA AVE, SAN DIMAS, CA 91773-3124
(909) 599-1248
(909) 599-7178
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(909) 599-7178
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
950000095
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC06291J
—
CA
05
—
LTC70110G
—
CA
Enumeration date
10/17/2006
Last updated
09/29/2023
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