P.G.H.C.C., Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

70000075 Issued in CA

Legal business name

P.G.H.C.C., INC

Doing business as

Pacific Grove Convalescent Hospital

Practice address

200 Lighthouse Ave
Pacific Grove, CA 93950-3022

Phone

(831) 375-2695

Fax

(831) 647-9639

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Douglas Lund

Title

Administrator

Phone

(805) 565-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Grove Convalescent Hospital Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1275614448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LIGHTHOUSE AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503022",
            "telephone_number": "831-375-2695",
            "fax_number": "831-647-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LIGHTHOUSE AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503022",
            "telephone_number": "831-375-2695",
            "fax_number": "831-647-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.G.H.C.C., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-565-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "70000075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05356G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Grove Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Pacific Grove, CA
• Providers in Pacific Grove, 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 Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.