Healthcare Provider Details

I. General information

NPI: 1851242374
Provider Name (Legal Business Name): PALOMAR UCSD HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15615 POMERADO RD
POWAY CA
92064-2405
US

IV. Provider business mailing address

2125 CITRACADO PKWY STE 300
ESCONDIDO CA
92029-4159
US

V. Phone/Fax

Practice location:
  • Phone: 858-613-4545
  • Fax:
Mailing address:
  • Phone:
  • 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: DIANE HANSEN
Title or Position: CEO
Credential:
Phone: 442-281-5000