NPIMap

Organization Active NPI

Broadview, Inc.

  • Religious Nonmedical Health Care Institution
  • Los Angeles, CA
National Provider Identifier
1417950445
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X
License
051991 Issued in CA
Legal business name
BROADVIEW, INC.
Practice address
4570 Griffin Ave
Los Angeles, CA 90031-1422
Phone
(323) 221-9174
Fax
(323) 221-7194
NPI assigned
May 23, 2005
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. Mark P Zundel-Waterson
Title
Business Manager
Phone
(323) 221-9174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Health Care Institution 282J00000X 051991 CA Primary

Addresses

Primary practice location

4570 Griffin Ave
Los Angeles, CA 90031-1422

Mailing address

4570 Griffin Ave
Los Angeles, CA 90031-1422
Phone (323) 221-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030326000027 CA Part A Provider - Religious Non-Medical Health Care Institution (Rnhci) 7719896935 Practice locations: Los Angeles, CA

Hospital certification: CCN 051991

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BROADVIEW INC
Certification status
Active
Provider type (POS)
Hospital – Religious non-medical health care institution
Participating since
Nov 28, 2000
Last certification
May 4, 2010
Beds
42
Ownership / control type
Church
Facility address
4570 Griffin Avenue
Los Angeles, CA 90031

National Provider Directory

National Provider Directory

Locations

4570 Griffin Ave
Los Angeles, CA 90031
Phone (323) 221-9174

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417950445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 GRIFFIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900311422",
            "telephone_number": "323-221-9174",
            "fax_number": "323-221-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 GRIFFIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900311422",
            "telephone_number": "323-221-9174",
            "fax_number": "323-221-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADVIEW, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZUNDEL-WATERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "323-221-9174",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": "CA",
            "license": "051991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.