PACIFIC GROVE CONVALESCENT HOSPITAL
NPI 1275614448
Skilled Nursing Facility in Pacific Grove, CA

Active since October 17, 2006CLIA 05D0590848 · Waiver
200 LIGHTHOUSE AVE, PACIFIC GROVE, CA 93950(831) 375-2695(831) 647-9639 Get Directions Write a Review

NPPES record last updated: July 29, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pacific Grove Convalescent Hospital NPPES

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

PACIFIC GROVE CONVALESCENT HOSPITAL (NPI 1275614448) is a healthcare organization registered as a skilled nursing facility in Pacific Grove, California and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists John Douglas Lund, Administrator, as its authorized official.

NPPES Registry Identity

NPI1275614448
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameP.G.H.C.C., INC
Location Address200 LIGHTHOUSE AVEPacific Grove, CA 93950-3022
Mailing Address200 Lighthouse AvePacific Grove, CA 93950-3022 · (831) 375-2695 · Fax (831) 647-9639
Fax(831) 647-9639
Organization SubpartNo
Authorized OfficialJohn Douglas LundAdministrator · (805) 565-5000
Enumeration DateOctober 17, 2006
Last NPPES UpdateJuly 29, 2014
NPI 1275614448 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 · 70000075
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.
200 LIGHTHOUSE AVE, Pacific Grove, CA 93950

Other Names 1

Doing Business AsPacific Grove Convalescent Hospital

Other Identifiers 2

Medicare OSCAR/certification055356CA
MedicaidZZR05356GCA

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 05D0590848

Pacific Grove Convalescent Hospital · Pacific Grove, CA
Active · expires Aug 31, 2026
CLIA Number05D0590848
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorNina F. Roberts
Laboratory Phone(408) 375-2695
Laboratory LocationPacific Grove Convalescent Hospital200 Lighthouse Ave, Pacific Grove, CA 93950
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Skilled Nursing Facility
200 LIGHTHOUSE AVE
PACIFIC GROVE, CA 93950

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 P.G.H.C.C., Inc's NPI number?

The NPI number for P.G.H.C.C., Inc is 1275614448. It was assigned to this organization in the NPPES registry on October 17, 2006. The provider is doing business as Pacific Grove Convalescent Hospital.

Where is P.G.H.C.C., Inc located?

P.G.H.C.C., Inc is located at 200 Lighthouse Ave, Pacific Grove, CA 93950. The listed phone number is (831) 375-2695.

What is P.G.H.C.C., Inc's specialty?

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

Does P.G.H.C.C., Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0590848) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for P.G.H.C.C., Inc was last updated on July 29, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.