MEDICARE: LVDN LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		CA

General Provider Information

NPI Number	:	1194821736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LVDN LTD.

Provider Business Mailing Address
First Line	:	9619 CHESAPEAKE DR
Second Line	:	SUITE 103
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1368
Country	:	US
Telephone Number	:	858-565-4424
Fax Number	:	858-565-2428

Provider Business Practice Location Address
First Line	:	1335 LAS VILLAS WAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-1921
Country	:	US
Telephone Number	:	760-741-1046
Fax Number	:	760-741-0221

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	B. RENEE BARNARD
Credential	:
Telephone Number	:	858-565-4424

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	08/22/2020

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