Organization
PARK VISTA POST ACUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL SOLORZANO (MANAGER)
(626) 346-0300
Entity
Organization
Contact information
Practice address
980 W 7TH ST, SAN JACINTO, CA 92582-3814
(951) 654-9347
Mailing address
107 W LEMON AVE, MONROVIA, CA 91016-2809
(626) 658-7344
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055598
MEDICARE PTAN
CA
05
—
ZZT05598H
—
CA
Enumeration date
05/24/2019
Last updated
05/24/2019
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