NPIMap

Organization Active NPI

3360 Magnolia Ave. Inc

Doing business as Vista Del Mar Senior Living

  • Assisted Living Facility
  • Long Beach, CA
National Provider Identifier
1174057186
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
197608029 Issued in CA
Legal business name
3360 MAGNOLIA AVE. INC
Doing business as
Vista Del Mar Senior Living
Practice address
3360 Magnolia Ave
Long Beach, CA 90806-1234
Phone
(562) 595-1559
NPI assigned
Apr 17, 2017
Last updated
Apr 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Mr. James Bender
Title
Vice President
Phone
(562) 595-1559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 197608029 CA Primary

Addresses

Primary practice location

3360 Magnolia Ave
Long Beach, CA 90806-1234

Mailing address

3360 Magnolia Ave
Long Beach, CA 90806-1234
Phone (562) 595-1559

Other names 1

  • Vista Del Mar Senior Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
3360 Magnolia Ave Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1174057186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 MAGNOLIA AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061234",
            "telephone_number": "562-595-1559",
            "fax_number": "562-427-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 MAGNOLIA AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061234",
            "telephone_number": "562-595-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3360 MAGNOLIA AVE. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "562-595-1559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197608029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Del Mar Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.