Organization
COMMUNITY CONVALESCENT HOSPITAL OF LA MESA LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB GRAFF (PRESIDENT)
(323) 556-0040
Entity
Organization
Contact information
Practice address
8665 LA MESA BLVD, LA MESA, CA 91941
(619) 465-0702
(619) 828-1782
Mailing address
8665 LA MESA BLVD, LA MESA, CA 91941-3903
(619) 465-0702
(619) 828-1782
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090000033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18070G
—
CA
Enumeration date
10/28/2005
Last updated
07/25/2018
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