Provider Demographics
NPI:1083070239
Name:CALIFORNIA POST-ACUTE CARE, LLC
Entity Type:Organization
Organization Name:CALIFORNIA POST-ACUTE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANEESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-349-7108
Mailing Address - Street 1:16660 PARAMOUNT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5457
Mailing Address - Country:US
Mailing Address - Phone:424-349-7108
Mailing Address - Fax:
Practice Address - Street 1:3615 E IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2652
Practice Address - Country:US
Practice Address - Phone:310-639-4623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055052Medicare Oscar/Certification