Organization
FOUNTAIN GARDENS CONVALESCENT HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK MARKOVITZ (OWNER)
(562) 761-7365
Entity
Organization
Contact information
Practice address
2222 SO SANTA ANA BLVD, LOS ANGELES, CA 90059
(323) 564-4461
(323) 569-9565
Mailing address
2222 SO SANTA ANA BLVD, LOS ANGELES, CA 90059
(323) 564-4461
(323) 569-9565
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
—
CA
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18416G
—
CA
Enumeration date
08/22/2005
Last updated
01/22/2008
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