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Organization
SAN GABRIEL VALLEY CONVALESCENT HOSPITAL, INC.
Active
Organization
SAN GABRIEL VALLEY CONVALESCENT HOSPITAL, INC.
Active
Other names
Penn Mar Therapeutic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORI DIMLA (ADMINISTRATOR)
(626) 401-1557
Entity
Organization
Contact information
Practice address
3938 COGSWELL RD, EL MONTE, CA 91732-2404
(626) 401-1557
Mailing address
3938 COGSWELL RD, EL MONTE, CA 91732-2404
(626) 401-1557
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05A360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC 10040F
—
CA
Enumeration date
09/20/2005
Last updated
08/22/2020
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