Healthcare Provider Details

I. General information

NPI: 1386462976
Provider Name (Legal Business Name): PARADISE BAY HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 PACIFIC AVE
LONG BEACH CA
90806-2612
US

IV. Provider business mailing address

16544 FRANZEN FARM RD
SAN DIEGO CA
92127-2240
US

V. Phone/Fax

Practice location:
  • Phone: 562-427-7493
  • Fax:
Mailing address:
  • Phone: 858-798-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TOBY TILFORD
Title or Position: CO-CEO
Credential:
Phone: 858-774-8342