Provider Demographics
NPI:1033108600
Name:FRAN-JOM, INC
Entity Type:Organization
Organization Name:FRAN-JOM, INC
Other - Org Name:TEMPLE CITY CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-443-3028
Mailing Address - Street 1:5101 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3682
Mailing Address - Country:US
Mailing Address - Phone:626-443-3028
Mailing Address - Fax:626-443-1988
Practice Address - Street 1:5101 TYLER AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-3682
Practice Address - Country:US
Practice Address - Phone:626-443-3028
Practice Address - Fax:626-443-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA950000101314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT18618GMedicaid
CA056413Medicare Oscar/Certification
CA0690680001Medicare NSC