Healthcare Provider Details

I. General information

NPI: 1770669236
Provider Name (Legal Business Name): AMERICAN HEALTH SERVICES OF SAN DIEGO, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 CAMINO DEL RIO S. SUITE 112
SAN DIEGO CA
92108-3755
US

IV. Provider business mailing address

2535 CAMINO DEL RIO S. SUITE 112
SAN DIEGO CA
92108-3755
US

V. Phone/Fax

Practice location:
  • Phone: 619-220-6980
  • Fax: 619-220-6981
Mailing address:
  • Phone: 619-220-6980
  • Fax: 619-220-6981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number080000771
License Number StateCA

VIII. Authorized Official

Name: MR. JOSHUA KAUFFMAN
Title or Position: VP
Credential:
Phone: 323-556-0040