SUNRAY HEALTHCARE CENTER
NPI 1023150042
Skilled Nursing Facility in Los Angeles, CA

Active since February 13, 2007CLIA 05D0898497 · Waiver
3210 W PICO BLVD, LOS ANGELES, CA 90019(323) 734-2171(323) 734-1825 Get Directions Write a Review

NPPES record last updated: June 9, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sunray Healthcare Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUNRAY HEALTHCARE CENTER (NPI 1023150042) is a healthcare organization registered as a skilled nursing facility in Los Angeles, California and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through March 2, 2027 and lists Douglas Easton, Manager, as its authorized official.

NPPES Registry Identity

NPI1023150042
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameBROADWATER SUNRAY CARE CENTER, LLC
Location Address3210 W PICO BLVDLos Angeles, CA 90019-3643
Mailing Address3210 W Pico BlvdLos Angeles, CA 90019-3643 · (323) 734-2171 · Fax (323) 734-1825
Fax(323) 734-1825
Organization SubpartNo
Authorized OfficialDouglas EastonManager · (818) 368-1862
Enumeration DateFebruary 13, 2007
Last NPPES UpdateJune 9, 2008
NPI 1023150042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 970000023
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
3210 W PICO BLVD, Los Angeles, CA 90019

Other Names 1

Doing Business AsSunray Healthcare Center

Other Identifiers 2

Medicare ID-Type Unspecified055870CA
Medicare NSC6083680001CA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0898497

Sunray Healthcare Center · Los Angeles, CA
Active · expires Mar 2, 2027
CLIA Number05D0898497
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMarch 3, 2025
Certificate Expiration DateMarch 2, 2027
Laboratory DirectorSheldon Reiss MD
Laboratory Phone(323) 734-2171
Laboratory LocationSunray Healthcare Center3210 West Pico Boulevard, Los Angeles, CA 90019
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
3210 W PICO BLVD
LOS ANGELES, CA 90019
Skilled Nursing Facility
3210 W PICO BLVD
LOS ANGELES, CA 90019

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadwater Sunray Care Center, LLC's NPI number?

The NPI number for Broadwater Sunray Care Center, LLC is 1023150042. It was assigned to this organization in the NPPES registry on February 13, 2007. The provider is doing business as Sunray Healthcare Center.

Where is Broadwater Sunray Care Center, LLC located?

Broadwater Sunray Care Center, LLC is located at 3210 W Pico Blvd, Los Angeles, CA 90019. The listed phone number is (323) 734-2171.

What is Broadwater Sunray Care Center, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Broadwater Sunray Care Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0898497) is associated with this NPI, valid through March 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Broadwater Sunray Care Center, LLC was last updated on June 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.