Provider Demographics
NPI:1306267208
Name:KINDRED HOSPITAL SOUTBAY
Entity type:Organization
Organization Name:KINDRED HOSPITAL SOUTBAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD BILLER/COLLECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABARCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-903-8765
Mailing Address - Street 1:14900 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14900 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2172
Practice Address - Country:US
Practice Address - Phone:562-903-8765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1821172586Medicare Oscar/Certification
CA1689984668Medicare Oscar/Certification
CA1215247978Medicare Oscar/Certification
CA1013227099Medicare Oscar/Certification
CA1205146289Medicare Oscar/Certification