1730266883 NPI number — AJIT HEALTHCARE INC.

Table of content: (NPI 1730266883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730266883 NPI number — AJIT HEALTHCARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AJIT HEALTHCARE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WESTLAKE CONVALESCENT HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730266883
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
316 SOUTH WESTLAKE AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-484-0510
Provider Business Mailing Address Fax Number:
213-484-5931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
316 SOUTH WESTLAKE AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-0510
Provider Business Practice Location Address Fax Number:
213-484-5931
Provider Enumeration Date:
11/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AUSTRIA
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
323-333-0509

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  970000073 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 056242 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: ZZT06242I , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZZT062421 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZT06242I , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".