NPIMap

Organization Active NPI

Pacific Gardens Medical Center, LLC

  • Rehabilitation Hospital Unit
  • Hawaiian Gardens, CA
National Provider Identifier
1376015966
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
PACIFIC GARDENS MEDICAL CENTER, LLC
Practice address
21530 Pioneer Blvd
Hawaiian Gardens, CA 90716-2608
Phone
(562) 860-0401
Fax
(562) 924-5871
NPI assigned
Dec 20, 2018
Organization subpart
Yes
Parent organization
PACIFIC GARDENS MEDICAL CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Mrs. Tammy Jean Thompson
Title
Executive Vice President, Cfo
Phone
(209) 287-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

21530 Pioneer Blvd
Hawaiian Gardens, CA 90716-2608

Mailing address

700 17TH St Ste 201D
Modesto, CA 95354-1249

National Provider Directory

National Provider Directory
Tax ID family
Pacific Gardens Medical Center LLC4 organizations share this tax ID, including this one
Part of
Pacific Gardens Medical Center LLC

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1376015966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 17TH ST STE 201D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21530 PIONEER BLVD",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162608",
            "telephone_number": "562-860-0401",
            "fax_number": "562-924-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC GARDENS MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC GARDENS MEDICAL CENTER, LLC",
        "enumeration_date": "2018-12-20",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "209-287-6308",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawaiian Gardens, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.