Healthcare Provider Details

I. General information

NPI: 1689257974
Provider Name (Legal Business Name): PACALDO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 VALE ST
DALY CITY CA
94014-2516
US

IV. Provider business mailing address

130 VALE ST
DALY CITY CA
94014-2516
US

V. Phone/Fax

Practice location:
  • Phone: 650-393-0265
  • Fax: 650-898-1553
Mailing address:
  • Phone: 650-393-0265
  • Fax: 650-898-1553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIET MIRANDA PACALDO
Title or Position: ADMINISTRATOR
Credential: RN MSN
Phone: 650-393-0265