1013002823 NPI number — TORRANCE CARE CENTER EAST, INC.

Table of content: (NPI 1013002823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013002823 NPI number — TORRANCE CARE CENTER EAST, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TORRANCE CARE CENTER EAST, 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:
TORRANCE CARE CENTER EAST
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:
1013002823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4315 TORRANCE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TORRANCE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90503-4401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-370-5611
Provider Business Mailing Address Fax Number:
310-793-7631

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4315 TORRANCE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90503-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-370-5611
Provider Business Practice Location Address Fax Number:
310-793-7631
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROLLINS
Authorized Official First Name:
VICKI
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
VICE-PESIDENT
Authorized Official Telephone Number:
310-370-5611

Provider Taxonomy Codes

  • 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: LTC06352G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8882433 . This is a "MEDICAL PIN NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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