Provider Demographics
NPI:1558605402
Name:TORREY PINES REHABILITATION HOSPITAL LLC
Entity Type:Organization
Organization Name:TORREY PINES REHABILITATION HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-266-1080
Mailing Address - Street 1:530 N PUENTE ST
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-2804
Mailing Address - Country:US
Mailing Address - Phone:310-266-1080
Mailing Address - Fax:714-256-2003
Practice Address - Street 1:1701 S TORREY PINES DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2999
Practice Address - Country:US
Practice Address - Phone:702-871-0005
Practice Address - Fax:702-871-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility