Healthcare Provider Details

I. General information

NPI: 1598840464
Provider Name (Legal Business Name): MGV HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8765 AERO DR SUITE 312
SAN DIEGO CA
92123-1781
US

IV. Provider business mailing address

8765 AERO DR SUITE 312
SAN DIEGO CA
92123-1781
US

V. Phone/Fax

Practice location:
  • Phone: 858-573-6837
  • Fax: 858-573-8917
Mailing address:
  • Phone: 858-573-6837
  • Fax: 858-573-8917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number080000744
License Number StateCA

VIII. Authorized Official

Name: MS. HELEN FELIX VIGILIA
Title or Position: PRESIDENT
Credential:
Phone: 858-573-6837