South Pasadena Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

970000038 Issued in CA

Legal business name

SOUTH PASADENA REHABILITATION CENTER, LLC

Doing business as

MIssion Grove Healthcare & Wellness Centre

Practice address

904 Mission St
South Pasadena, CA 91030-3144

Phone

(626) 799-9571

Fax

(626) 799-2734

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Guy Reggev

Title

Member

Phone

(626) 799-9571

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MIssion Grove Healthcare & Wellness Centre Doing business as

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1699780064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 MISSION ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303144",
            "telephone_number": "626-799-9571",
            "fax_number": "626-799-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 MISSION ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303144",
            "telephone_number": "626-799-9571",
            "fax_number": "626-799-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PASADENA REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "REGGEV",
        "authorized_official_first_name": "GUY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "626-799-9571",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05931G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIssion Grove Healthcare & Wellness Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Daniel Fred Spector, PH.D.
• Vincent Frank Spero, DDS
• Catherine Spicer, LMFT

• Skilled Nursing Facility in South Pasadena, CA
• Providers in South Pasadena, 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 Mar 20, 2015; 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.