Organization
MID-WILSHIRE HEALTH CARE CENTER, INC
Active
Other names
TUSTIN CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEOUNG HIE LEE (PRESIDENT)
(323) 934-5660
Entity
Organization
Contact information
Practice address
1051 BRYAN AVE, TUSTIN, CA 92780-4419
(714) 832-6780
(714) 832-1031
Mailing address
1101 CRENSHAW BLVD, LOS ANGELES, CA 90019-3112
(323) 934-5660
(323) 934-0852
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT11108H
—
CA
Enumeration date
11/16/2006
Last updated
10/16/2009
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