Provider Demographics
NPI:1003471541
Name:AZTEC HEALTHCARE LLC
Entity Type:Organization
Organization Name:AZTEC HEALTHCARE LLC
Other - Org Name:AZTEC HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-405-3399
Mailing Address - Street 1:4601 WILSHIRE BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3883
Mailing Address - Country:US
Mailing Address - Phone:323-405-3399
Mailing Address - Fax:
Practice Address - Street 1:500 CARE LN
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-1552
Practice Address - Country:US
Practice Address - Phone:505-334-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility