Organization
SAN PEDRO CONVALESCENT HOME, INC.
Active
Other names
LOS PALOS CONVALESCENT HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CELIA VALDOMAR NHA (ADMINISTRATOR)
(310) 832-6431
Entity
Organization
Contact information
Practice address
1430 W 6TH ST, SAN PEDRO, CA 90732-3503
(310) 832-6431
(310) 832-3390
Mailing address
1430 W 6TH ST, SAN PEDRO, CA 90732-3503
(310) 832-6431
(310) 832-3390
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05527F
—
CA
Enumeration date
12/01/2006
Last updated
03/06/2008
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