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NPI 1114338522 · Nursing Facility/Intermediate Care Facility · Los Angeles, CA
Provider details
- NPI number
- 1114338522
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Shawn Miyake, President and Ceo(323) 980-7500
- License
- 970000039 (CA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
325 S Boyle Ave
Los Angeles, CA 90033-3812
Phone: (323) 980-7530
Fax: (323) 263-2721
Street-level locationGet directions
Mailing address
325 S Boyle Ave
Los Angeles, CA 90033-3812
Other names (DBA / former)
- Doing business as
- Keiro Intermediate Care Facility
Registry dates
- Enumerated
- 2014-05-20
- Last updated
- 2014-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.