Pavilion Healthcare Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

910000145 Issued in CA

Legal business name

PAVILION HEALTHCARE CENTER LLC

Doing business as

Pavilion Healthcare Center

Practice address

5916 W Pico Blvd
Los Angeles, CA 90035-2615

Phone

(323) 939-3184

Fax

(323) 939-1966

NPI assigned

Apr 11, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Reissman

Title

Ceo/Chairman

Phone

(310) 574-3733

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pavilion Healthcare Center Doing business as

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1790041010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 W GOLDLEAF CIR STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561297",
            "telephone_number": "323-596-2145",
            "fax_number": "323-596-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352615",
            "telephone_number": "323-939-3184",
            "fax_number": "323-939-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "REISSMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO/CHAIRMAN",
        "authorized_official_telephone_number": "310-574-3733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "910000145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05160G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pavilion Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shital Pavawalla, PH.D.
• Pavel Gryunshpan Chiropractic Inc
• Clara Ivet Pavesi-Krieger, MD
• Geraldine Pavez, ACNP
• Tom Pavich, LMFT
• Pavilion on Pico Healthcare & Wellness Centre, LP
• Eric Pavlics
• Jillian Olivia Pavloff
• Hannah Pavlov
• Zdena Anna Pavlova, MD

• Skilled Nursing Facility in Los Angeles, CA
• Providers in Los Angeles, 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 Apr 11, 2012; 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.