Organization
WEST ANAHEIM EXTENDED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LLAMADO (OFFICE MANAGER)
(714) 821-1993
Entity
Organization
Contact information
Practice address
645 S BEACH BLVD, ANAHEIM, CA 92804-3102
(714) 821-1993
(714) 821-8450
Mailing address
645 S BEACH BLVD, ANAHEIM, CA 92804-3102
(714) 821-1993
(714) 821-8450
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060000255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55388G
—
CA
Enumeration date
09/16/2006
Last updated
08/27/2015
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