Organization
PAVILION HEALTHCARE CENTER LLC
Active
Other names
Pavilion Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN REISSMAN (CEO/CHAIRMAN)
(310) 574-3733
Entity
Organization
Contact information
Practice address
5916 W PICO BLVD, LOS ANGELES, CA 90035-2615
(323) 939-3184
(323) 939-1966
Mailing address
5120 W GOLDLEAF CIR STE 400, LOS ANGELES, CA 90056-1297
(323) 596-2145
(323) 596-4645
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000145
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05160G
—
CA
Enumeration date
04/11/2012
Last updated
04/11/2012
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