NPIMap

Organization Active NPI

Jomi Alta5 Icfdd N

  • Nursing Facility/Intermediate Care Facility
  • Altadena, CA
National Provider Identifier
1124169537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
JOMI ALTA5 ICFDD N
Practice address
2075 El Molino Ave
Altadena, CA 91001-3051
Phone
(626) 791-1321
Fax
(818) 841-4403
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Roger V Cuevas
Title
Business Manager
Phone
(818) 841-1044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X CA Primary

Addresses

Primary practice location

2075 El Molino Ave
Altadena, CA 91001-3051

Mailing address

1849 Ayers Way
Burbank, CA 91501-1106
Phone (818) 841-1044

Other names 1

  • JOMI ICFDDN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jo Mi Icf DDN Facilities3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124169537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 AYERS WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915011106",
            "telephone_number": "818-841-1044",
            "fax_number": "818-841-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 EL MOLINO AVE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013051",
            "telephone_number": "626-791-1321",
            "fax_number": "818-841-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOMI ALTA5 ICFDD N",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "818-841-1044",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOMI ICFDDN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Altadena, CA

Sources for this page

  • 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.