Organization
BONNIE BRAE CONVALESCENT HOSPITAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELMA B. CAYTON (CHIEF EXECUTIVE OFFICER)
(213) 483-8144
Entity
Organization
Contact information
Practice address
420 S BONNIE BRAE ST, LOS ANGELES, CA 90057-3010
(213) 483-8144
(213) 483-6145
Mailing address
420 S BONNIE BRAE ST, LOS ANGELES, CA 90057-3010
(213) 483-8144
(213) 483-1414
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000062
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05538G
—
CA
Enumeration date
01/17/2007
Last updated
11/21/2013
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