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General NPI Number Information
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NPI Number | 1043750516
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Entity Type | Organization
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Legal Business Name | WESTERN HEALTH PRIVATE HOMECARE
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Dates
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Enumeration Date | 03/03/2017
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 591 CAMINO DE LA REINA STE 1010
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City | SAN DIEGO
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State | CA
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Zip | 92108-3112
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Country | US
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Telephone | 619-865-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 5838 EDISON PL STE 201
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City | CARLSBAD
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State | CA
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Zip | 92008-5520
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Country | US
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Telephone | 619-865-2400
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BRIAN TWIGGER
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Credential |
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Telephone | 619-865-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 08000048
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License Number State | CA
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