Healthcare Provider Details

I. General information

NPI: 1801698576
Provider Name (Legal Business Name): CAMINO DEL RIO HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 CAMINO DEL RIO S STE 120
SAN DIEGO CA
92108-3764
US

IV. Provider business mailing address

2535 CAMINO DEL RIO S STE 120
SAN DIEGO CA
92108-3764
US

V. Phone/Fax

Practice location:
  • Phone: 619-220-6980
  • Fax:
Mailing address:
  • Phone: 619-220-6980
  • 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: AMBER TUELLER
Title or Position: SECRETARY
Credential:
Phone: 208-207-2726