Pacifica Royale Assisted Living Community, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

306001848 Issued in CA

Legal business name

PACIFICA ROYALE ASSISTED LIVING COMMUNITY, INC.

Practice address

15022 Pacific St
Midway City, CA 92655-1452

Phone

(714) 892-4446

NPI assigned

Jul 31, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Edward Maslobodsky

Title

Administrator

Phone

(714) 588-3047

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1558779694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15022 PACIFIC ST",
            "city": "MIDWAY CITY",
            "state": "CA",
            "postal_code": "926551452",
            "telephone_number": "714-892-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15022 PACIFIC ST",
            "city": "MIDWAY CITY",
            "state": "CA",
            "postal_code": "926551452",
            "telephone_number": "714-892-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA ROYALE ASSISTED LIVING COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "MASLOBODSKY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "714-588-3047",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "306001848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Miotla-Metz
• Erin Nicole Motschenbacher
• Khanh Nguyen Vu
• Ky Nguyen
• Thuan Nguyen, DDS
• Brian Jonathan Pang
• Jonathan Rivera
• Marisa Jessie Rodriguez
• Humera Sheikh, ACSW
• Thinh Duc Tran, PHARM.D.

• Assisted Living Facility in Midway City, CA
• Providers in Midway City, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.