Provider Demographics
NPI:1104018423
Name:SKILLED FACILITY HEALTH CARE SOLUTIONS INC
Entity type:Organization
Organization Name:SKILLED FACILITY HEALTH CARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANVAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-445-5999
Mailing Address - Street 1:3746 FOOTHILL BLVD # B140
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1740
Mailing Address - Country:US
Mailing Address - Phone:310-445-5999
Mailing Address - Fax:323-544-4248
Practice Address - Street 1:5455 S CENTINELA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6942
Practice Address - Country:US
Practice Address - Phone:310-445-5999
Practice Address - Fax:323-544-4248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208600000X, 310400000X, 315D00000X
CAA86336208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2861038Medicaid