MEDICARE: FOUR SULLIVAN ENTERPRISES 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1841127545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR SULLIVAN ENTERPRISES INC.

Provider Business Mailing Address
First Line	:	135 VALLECITOS DE ORO STE D
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92069-1461
Country	:	US
Telephone Number	:	760-736-9934
Fax Number	:	760-736-3162

Provider Business Practice Location Address
First Line	:	135 VALLECITOS DE ORO STE D
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92069-1461
Country	:	US
Telephone Number	:	760-736-9934
Fax Number	:	760-736-3162

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAIME MICHELLE DILL
Credential	:
Telephone Number	:	760-736-9934

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

Similar Medicare Providers

1528081478 — DR. HYUN JOO CHUNG O.D.
Practice Location Address:

1936 SW MILITARY DR , STE A.
SAN ANTONIO, TX
78221-1461

Practice Phone: 210-932-2092
Practice Fax:

1659478980 — EYEMASTERS OF TEXAS LTD
Practice Location Address:

1936 SW MILITARY DR
SAN ANTONIO, TX
78221-1461

Practice Phone: 210-923-4363
Practice Fax: 210-923-4617

1023107414 — AARON WALLACE
Practice Location Address:

1922 THE ALAMEDA STE 316
SAN JOSE, CA
95126-1461

Practice Phone: 408-261-7777
Practice Fax:

1871718528 — GENE (GERALD) EUGENE LAKE M.D.
Practice Location Address:

230 W LAUREL ST , UNIT 703
SAN DIEGO, CA
92101-1461

Practice Phone: 619-595-1564
Practice Fax: 858-720-8285

1255628582 — SAN PEDRO SMILES P.A.
Practice Location Address:

5101 SAN PEDRO AVE , SUITE 102
SAN ANTONIO, TX
78212-1461

Practice Phone: 210-737-6900
Practice Fax: 210-737-6904

1750668372 — VISIONWORKS, INC.
Practice Location Address:

1936 SW MILITARY DR
SAN ANTONIO, TX
78221-1461

Practice Phone: 210-923-4363
Practice Fax: 210-923-4617

Directions to “FOUR SULLIVAN ENTERPRISES INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.