Broadwater Sunray Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

970000023 Issued in CA

Legal business name

BROADWATER SUNRAY CARE CENTER, LLC

Doing business as

Sunray Healthcare Center

Practice address

3210 W Pico Blvd
Los Angeles, CA 90019-3643

Phone

(323) 734-2171

Fax

(323) 734-1825

NPI assigned

Feb 13, 2007

Last updated

Jun 9, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Douglas Easton

Title

Manager

Phone

(818) 368-1862

Specialties & licenses 1

Addresses

Other names 1

• Sunray Healthcare Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1023150042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193643",
            "telephone_number": "323-734-2171",
            "fax_number": "323-734-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193643",
            "telephone_number": "323-734-2171",
            "fax_number": "323-734-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWATER SUNRAY CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "EASTON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-368-1862"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunray Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.