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General NPI Number Information
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NPI Number | 1114336567
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Entity Type | Organization
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Legal Business Name | ANGELICUM HOME HEALTH, INC.
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 3914 MURPHY CANYON RD STE A166
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City | SAN DIEGO
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State | CA
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Zip | 92123-4415
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Country | US
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Telephone | 858-495-0400
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Fax | 858-496-9200
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Provider Business Mailing Address
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Address Line | 3914 MURPHY CANYON RD STE A166
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City | SAN DIEGO
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State | CA
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Zip | 92123-4415
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Country | US
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Telephone | 858-495-0400
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Fax | 858-496-9200
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR/CEO
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Name | HAZEL ANN ASUNCION HERNANDEZ
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Credential |
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Telephone | 858-495-0400
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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 | 550003335
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License Number State | CA
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