Healthcare Provider Details

I. General information

NPI: 1255344800
Provider Name (Legal Business Name): CLOISTERS NURSING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 12/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 REYNARD WAY
SAN DIEGO CA
92103-3847
US

IV. Provider business mailing address

3680 REYNARD WAY
SAN DIEGO CA
92103-3847
US

V. Phone/Fax

Practice location:
  • Phone: 619-297-4484
  • Fax:
Mailing address:
  • Phone: 619-297-4484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number080000032
License Number StateCA

VIII. Authorized Official

Name: MS. MARY MILLER
Title or Position: CHIEF LEGAL COUNSEL
Credential:
Phone: 619-441-8771