Organization
LA MIRADA HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABE BAK (OWNER)
(818) 985-6600
Entity
Organization
Contact information
Practice address
11926 LA MIRADA BLVD, LA MIRADA, CA 90638-1303
(818) 985-6600
Mailing address
11926 LA MIRADA BLVD, LA MIRADA, CA 90638-1303
(818) 985-6600
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
940000094
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT056115J
—
CA
Enumeration date
05/15/2014
Last updated
11/18/2014
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