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Organization

CRPA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLINE TAPANG DITULLIO (CO-MANAGER)
(626) 523-8956
Entity
Organization

Contact information

Practice address
525 S CENTRAL AVE, GLENDALE, CA 91204-2006
(818) 240-1610
(818) 845-1169
Mailing address
4016 GRAND AVE STE A-1056, CHINO, CA 91710-5491
(626) 523-8956
(626) 657-2776

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZT06190F
CA
Enumeration date
10/11/2022
Last updated
10/11/2022
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