Healthcare Provider Details

I. General information

NPI: 1679674642
Provider Name (Legal Business Name): SKCAY ENTERPRISES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15725 POMERADO RD SUITE 115
POWAY CA
92064-2068
US

IV. Provider business mailing address

15725 POMERADO RD SUITE 115
POWAY CA
92064-2068
US

V. Phone/Fax

Practice location:
  • Phone: 858-675-7766
  • Fax: 858-675-0043
Mailing address:
  • Phone: 858-675-7766
  • Fax: 858-675-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY BERRY
Title or Position: PRESIDENT & C.F.O.
Credential:
Phone: 858-675-7766