Organization
AG WEST COVINA, LLC
Active
Other names
West Covina Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WINTNER (MANAGER)
(323) 651-1808
Entity
Organization
Contact information
Practice address
850 SOUTH SUNKIST AVENUE, WEST COVINA, CA 91790
(626) 962-3368
(626) 338-3978
Mailing address
850 SOUTH SUNKIST AVENUE, WEST COVINA, CA 91790
(626) 962-3368
(310) 574-1322
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
950000014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05992I
—
CA
Enumeration date
09/09/2005
Last updated
07/21/2014
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