Japanese Home for the Aged

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

970000039 Issued in CA

Legal business name

JAPANESE HOME FOR THE AGED

Doing business as

Keiro Intermediate Care Facility

Practice address

325 S Boyle Ave
Los Angeles, CA 90033-3812

Phone

(323) 980-7530

Fax

(323) 263-2721

NPI assigned

May 20, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Shawn Miyake

Title

President and Ceo

Phone

(323) 980-7500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Keiro Intermediate Care Facility Doing business as

Tax ID family

Japanese Home for the Aged2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Japanese Home for the Aged

  • Nursing Facility/Intermediate Care Facility
  • Los Angeles, CA
  • NPI 1063512978
  NPD tax ID

Locations

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1114338522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S BOYLE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900333812",
            "telephone_number": "323-980-7530",
            "fax_number": "323-263-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S BOYLE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900333812",
            "telephone_number": "323-980-7530",
            "fax_number": "323-263-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAPANESE HOME FOR THE AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "MIYAKE",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "323-980-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "970000039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC90079F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keiro Intermediate Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Anne Janyszek, PT
• Carla Janzen, MD
• Justiniano Suarez Jaojoco, RN
• Japanese Healing Inc
• Japanese Home for the Aged
• Jenny Mariella Jaque, M.D.
• Alyssa Danielle Jaquez
• Javier Eliecer Jara, D.D.S
• Valery Jara
• Kamyar Jarahzadeh

• Nursing Facility/Intermediate Care Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.