Healthcare Provider Details

I. General information

NPI: 1346176963
Provider Name (Legal Business Name): GROSSMONT HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16752 VALLE VERDE ROAD
POWAY CA
92064
US

IV. Provider business mailing address

8695 SPECTRUM CENTER BLVD
SAN DIEGO CA
92123-1489
US

V. Phone/Fax

Practice location:
  • Phone: 619-667-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SCOTT EVANS
Title or Position: CEO
Credential:
Phone: 619-740-4648