Provider Demographics
NPI:1346238938
Name:ROYAL SORENSON LLC
Entity Type:Organization
Organization Name:ROYAL SORENSON LLC
Other - Org Name:SORENSON CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:FLORO
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-965-0600
Mailing Address - Street 1:7931 SORENSEN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2418
Mailing Address - Country:US
Mailing Address - Phone:562-698-0451
Mailing Address - Fax:562-945-6451
Practice Address - Street 1:7931 SORENSEN AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2418
Practice Address - Country:US
Practice Address - Phone:562-698-0451
Practice Address - Fax:562-945-6451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-08
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346238938OtherNPI
CAZZT05168GMedicaid
CA055168Medicare ID - Type Unspecified