Provider Demographics
NPI:1528056116
Name:EDINBURG MANAGEMENT ASSOCIATES INC
Entity type:Organization
Organization Name:EDINBURG MANAGEMENT ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:2339 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1931
Mailing Address - Country:US
Mailing Address - Phone:626-289-7809
Mailing Address - Fax:626-289-6475
Practice Address - Street 1:2339 W VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-1931
Practice Address - Country:US
Practice Address - Phone:626-289-7809
Practice Address - Fax:626-289-6475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05818GMedicaid
CA055818Medicare ID - Type Unspecified