Organization
SAN GABRIEL VALLEY CONVALESCENT HOSPITAL, INC.
Active
Other names
Penn Mar Therapeutic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORI DIMLA (ADMINISTRATOR)
(626) 401-1557
Entity
Organization
Contact information
Practice address
3938 COGSWELL RD, EL MONTE, CA 91732-2404
(626) 401-1557
Mailing address
3938 COGSWELL RD, EL MONTE, CA 91732-2404
(626) 401-1557
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05A360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC 10040F
—
CA
Enumeration date
09/20/2005
Last updated
08/22/2020
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