Healthcare Provider Details

I. General information

NPI: 1336822667
Provider Name (Legal Business Name): SKILLED BOBIER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 E BOBIER DR
VISTA CA
92084-3026
US

IV. Provider business mailing address

247 E BOBIER DR
VISTA CA
92084-3026
US

V. Phone/Fax

Practice location:
  • Phone: 760-945-3033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SCOTT KIRBY
Title or Position: MANAGER
Credential:
Phone: 619-201-5888