Edward E Cruz, ARF CERTIFIED
Individual provider Active NPI Nursing Home Administrator · Artesia, CA
NPI 1093587644 · NPPES record last updated Oct 26, 2023
Key facts
- NPI
- 1093587644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nursing Home Administrator 376G00000X
- License
- 6044600735 (CA)
- Practice address
- 11954 166TH St
Artesia, CA 90701-1816 - Phone
- (714) 659-9152
- NPI assigned
- Oct 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6044600735 | CA | MD | Nursing Home Administrator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 6044600735 | CA | Yes |
Addresses
Primary practice location
11954 166TH St
Artesia, CA 90701-1816
Mailing address
11954 166TH St
Artesia, CA 90701-1816
Phone (714) 659-9152
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- Brandy Coward
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- Stephen Curry
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All providers in Artesia, CA · Nursing Home Administrator in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.