Organization
1450 NORTH FAIR OAKS LLC
Active
Other names
Golden Cross Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEMAR MERCADO (MANAGING MEMBER)
(626) 305-0281
Entity
Organization
Contact information
Practice address
1450 N FAIR OAKS AVE, PASADENA, CA 91103-1801
(626) 791-1948
(626) 791-9282
Mailing address
1450 N FAIR OAKS AVE, PASADENA, CA 91103-1801
(626) 791-1948
(626) 791-9282
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000082
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55096H
—
CA
Enumeration date
12/17/2010
Last updated
12/17/2010
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