Organization
CULVER WEST CONVALESCENT HOSPITAL
Active
Other names
Culver West Convalescent Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYON EUGENE MOONEY JR. ADMIN IN TRAINING (ADMINISTRATOR IN TRAINING)
(310) 390-9506
Entity
Organization
Contact information
Practice address
4035 GRAND VIEW BLVD, LOS ANGELES, CA 90066-5211
(310) 390-9506
(310) 391-1974
Mailing address
4035 GRAND VIEW BLVD, LOS ANGELES, CA 90066-5211
(310) 390-9506
(310) 391-1974
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000038
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05350G
—
CA
Enumeration date
10/14/2005
Last updated
05/29/2012
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