Provider Demographics
NPI:1225227804
Name:INTEGRATED NURSING AND REHAB CARE OF GLENDORA INC.
Entity Type:Organization
Organization Name:INTEGRATED NURSING AND REHAB CARE OF GLENDORA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IT CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:DILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:NIRANJANA
Authorized Official - Suffix:
Authorized Official - Credentials:IT CONSULTANT
Authorized Official - Phone:626-736-6373
Mailing Address - Street 1:805 W ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-5413
Mailing Address - Country:US
Mailing Address - Phone:626-736-6373
Mailing Address - Fax:626-332-8835
Practice Address - Street 1:805 W ARROW HWY
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5413
Practice Address - Country:US
Practice Address - Phone:626-736-6373
Practice Address - Fax:626-332-8835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056079Medicare Oscar/Certification