Brookside Post Acute LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2400000323 Issued in CA

Legal business name

BROOKSIDE POST ACUTE LLC

Practice address

1875 Barton Rd
Redlands, CA 92373-5308

Phone

(909) 793-1382

Fax

(909) 798-6689

NPI assigned

Sep 5, 2018

Organization subpart

No

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

Authorized official

Name

Crystal Solorzano

Title

Manager

Phone

(626) 346-0300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1457833444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W LEMON AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162809",
            "telephone_number": "323-836-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 BARTON RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735308",
            "telephone_number": "909-793-1382",
            "fax_number": "909-798-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "SOLORZANO",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "626-346-0300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "2400000323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "555379",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Brockardt, M.D.
• Douglas C Brockmann, M.D.
• Brockton Podiatry Group a Prof Corp
• Sophia Broderick, LPCC
• Diane Brodersen Eppler, LMFT
• Dale Broome, M.D.
• Taylor Broughton, PSYD
• Allan Wilton Brown, PHD
• Candace Brown, LIC. MARRIAGE & FAMI
• Hallie Renee McCormick Brown

• Skilled Nursing Facility in Redlands, CA
• Providers in Redlands, 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 Sep 5, 2018; 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.