Organization
CASA BONITA CONVALESCENT HOSPITAL LLC
Active
Other names
Casa Bonita Convalescent Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
IRA DAVID FRIEDMAN (MANAGER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
535 E BONITA AVE, SAN DIMAS, CA 91773-3124
(909) 599-1248
(909) 599-7178
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(909) 599-7178
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
950000095
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC06291J
—
CA
05
—
LTC70110G
—
CA
Enumeration date
10/17/2006
Last updated
09/29/2023
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