Citrus Breeze Villa LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CITRUS BREEZE VILLA LLC

Practice address

1009 S Citrus St
West Covina, CA 91791-3403

Phone

(714) 423-4629

NPI assigned

Oct 22, 2024

Organization subpart

No

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

Authorized official

Name

Yom Tekesta

Title

Licensee

Phone

(714) 423-4629

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1770304792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 S CITRUS ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917913403",
            "telephone_number": "714-423-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 S CITRUS ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917913403",
            "telephone_number": "714-423-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS BREEZE VILLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "TEKESTA",
        "authorized_official_first_name": "YOM",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "714-423-4629"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Chung, MD
• Esther Chung
• Joseph Edward Ciatti
• Alycia Cisneros
• Jesus Cisneros
• Citrus Medical Imaging Associates, Inc.
• Citrus Obstetrics &Gynecology Medical Associates Inc
• Citrus Treatment Center
• Citrus Valley Anesthesia Medical Group
• Citrus Valley Physician Partners

• All providers in West Covina, CA
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.