San Gabriel Medical Investors, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAN GABRIEL MEDICAL INVESTORS, LLC

Doing business as

Life Care Center of San Gabriel

Practice address

909 W Santa Anita St
San Gabriel, CA 91776-1018

Phone

(626) 289-5365

Fax

(626) 289-9503

NPI assigned

Jun 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Eunice R Fletcher

Title

Sr. Executive Director

Phone

(626) 289-5365

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LIFE CARE CENTER OF SAN GABRIEL Doing business as

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831125608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W SANTA ANITA ST",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761018",
            "telephone_number": "626-289-5365",
            "fax_number": "626-289-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W SANTA ANITA ST",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761018",
            "telephone_number": "626-289-5365",
            "fax_number": "626-289-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL MEDICAL INVESTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "EUNICE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SR. EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-289-5365",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05105N",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFE CARE CENTER OF SAN GABRIEL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cecilia Samartin, MFT
• San Gabriel Clinical Laboratories
• San Gabriel Family Dentistry
• San Gabriel Healthcare & Wellness Centre, LP (Ivy Creek Healthcare & Wellness Centre)
• San Gabriel Medical Investors, LLC (Life Care Center of San Gabriel)
• San Gabriel Nephrology Services LLC (Quality Dialysis Center)
• San Gabriel Pharmacy Inc
• San Gabriel Post Acute LLC
• San Gabriel Retina PC
• San Gabriel Unified School District

• Skilled Nursing Facility in San Gabriel, CA
• Providers in San Gabriel, 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 Aug 22, 2020; 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.