1450 North Fair Oaks LLC
Organization Active NPI Skilled Nursing Facility · Pasadena, CA
NPI 1669775326 · NPPES record last updated Dec 17, 2010
Key facts
- NPI
- 1669775326
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 970000082 (CA)
- Legal business name
- 1450 NORTH FAIR OAKS LLC
- Practice address
- 1450 N Fair Oaks Ave
Pasadena, CA 91103-1801 - Phone
- (626) 791-1948
- Fax
- (626) 791-9282
- NPI assigned
- Dec 17, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Josemar Mercado
- Title
- Managing Member
- Phone
- (626) 305-0281
National Provider Directory
Locations
1450 N Fair Oaks Ave
Pasadena, CA 91103
Phone (626) 791-1948
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 970000082 | CA | Yes |
Addresses
Primary practice location
1450 N Fair Oaks Ave
Pasadena, CA 91103-1801
Mailing address
1450 N Fair Oaks Ave
Pasadena, CA 91103-1801
Phone (626) 791-1948
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC55096H | Medicaid | CA |
Other names
- Golden Cross Health Care
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All providers in Pasadena, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.