Pavillion Healthcare Services

LBN: Pavillion Healthcare Services
Pavillion Healthcare Services is an health care organization with primary practice located at 20930 Bonita St Suite Y, Carson CA 90746-3680. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Pavillion Healthcare Services can be contacted via phone (310) 532-3464, or through Okon, Martin via phone (310) 532-3464.

Contact Information

Primary practice address
20930 Bonita St Suite Y Carson CA 90746-3680
Phone: (310) 532-3464
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Okon, Martin
Phone: (310) 532-3464

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 59793A California

Profile Details

NPI number 1124163100
LBN Legal business name Pavillion Healthcare Services
DBA Doing business as
Authorized official Okon, Martin
Entity Organization
Organization subpart 1 No
Enumeration date Feb 20th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124163100 NPPES
California MEDICAID 7163

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