Culver West Convalescent Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

910000038 Issued in CA

Legal business name

CULVER WEST CONVALESCENT HOSPITAL

Practice address

4035 Grand View Blvd
Los Angeles, CA 90066-5211

Phone

(310) 390-9506

Fax

(310) 391-1974

NPI assigned

Oct 14, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Bryon Eugene Mooney Jr., ADMIN IN TRAINING

Title

Administrator in Training

Phone

(310) 390-9506

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Culver West Convalescent Hospital Doing business as

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1083603880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 GRAND VIEW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665211",
            "telephone_number": "310-390-9506",
            "fax_number": "310-391-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 GRAND VIEW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665211",
            "telephone_number": "310-390-9506",
            "fax_number": "310-391-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULVER WEST CONVALESCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "BRYON",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "ADMINISTRATOR IN TRAINING",
        "authorized_official_telephone_number": "310-390-9506",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "ADMIN IN TRAINING"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "910000038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05350G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Culver West Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Lago Culp
• Wendell Harrison Culp, RCP
• Cassie Culpepper
• Tywanna Renee Culpepper
• Culturacare Treatment Services
• Culver West Health Center, LLC
• Marcela Bustamante Culver, LCSW
• Najwa Culver, PHD
• Tricia Culverhouse, N.P.
• Marie Louise Estacio Cumigad, MD

• 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 May 29, 2012; 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.