NPI 1801937214
Jomi Broadmoor Icfddn
Practice location
- Address
- 1547 S Broadmoor Ave, West Covina, CA 91790-4709
- Phone
- (626) 917-1833
- Fax
- (818) 841-4403
- Mailing address
- 1849 Ayers Way, Burbank, CA 91501-1106
Authorised official
- Name
- Roger V Cuevas
- Title
- Business Manager
- Phone
- (818) 841-1044
Registered specialties
Nursing Facility/Intermediate Care Facility
Primary
Registry record
- NPI
- 1801937214
- Entity type
- Organization
- NPI issued
- 9 Feb 2007
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.