Healthcare Provider Details

I. General information

NPI: 1811395353
Provider Name (Legal Business Name): GRANDCARE SAN DIEGO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 09/02/2025
Certification Date: 08/28/2025
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

3452 E FOOTHILL BLVD STE 130
PASADENA CA
91107-6006
US

V. Phone/Fax

Practice location:
  • Phone: 619-220-6980
  • Fax: 619-220-6981
Mailing address:
  • Phone: 866-554-2447
  • 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: DAVID ALLEN BELL
Title or Position: CEO
Credential:
Phone: 626-788-9798