Knott Avenue Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

KNOTT AVENUE CARE CENTER, INC.

Practice address

9021 Knott Ave
Buena Park, CA 90620-4138

Phone

(714) 826-2330

Fax

(714) 527-6869

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Elizabeth J. Casey

Title

Cfo

Phone

(805) 497-7330

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114969540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 E THOUSAND OAKS BLVD",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623402",
            "telephone_number": "805-497-7330",
            "fax_number": "805-497-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 KNOTT AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204138",
            "telephone_number": "714-826-2330",
            "fax_number": "714-527-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOTT AVENUE CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-497-7330"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70154F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05674I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Giyoun Ko, L.AC.
• Eun Bee Koh
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• Viral Kothary, PHARM.D., BCPS, BCGP

• Skilled Nursing Facility in Buena Park, CA
• Providers in Buena Park, 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 Aug 22, 2020; 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.