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NPI Code Detail

MEDICARE: RENAISSANCE HOME HEALTH CARE INC.

MEDICARE: RENAISSANCE HOME HEALTH CARE INC.
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
1251E00000XHome Health Agency080000782CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080000782OTHERCAHOME HEALTH LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356343396
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAISSANCE HOME HEALTH CARE INC.
Provider Business Mailing Address
First Line : 3160 CAMINO DEL RIO S STE 312
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3835
Country : US
Telephone Number : 619-285-1505
Fax Number : 619-285-1605
Provider Business Practice Location Address
First Line : 3160 CAMINO DEL RIO S STE 312
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3835
Country : US
Telephone Number : 619-285-1505
Fax Number : 619-285-1605
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. PAULA JEAN EGBERT
Credential : RN, MSN
Telephone Number : 619-285-1505
Provider Enumeration Date : 08/10/2005
Last Update Date : 03/07/2013

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Directions to “RENAISSANCE HOME HEALTH CARE INC. ” Practice Location

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