Healthcare Provider Details

I. General information

NPI: 1982953758
Provider Name (Legal Business Name): DELTA HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9948 HIBERT ST SUITE 105
SAN DIEGO CA
92131-1032
US

IV. Provider business mailing address

9948 HIBERT ST SUITE 105
SAN DIEGO CA
92131-1032
US

V. Phone/Fax

Practice location:
  • Phone: 888-458-0388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GRACE PAGADOR
Title or Position: ADMINISTRATOR
Credential:
Phone: 888-458-0388