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NPI 1205806676

NPI 1205806676 : PALOMAR HEALTH : SAN MARCOS, CA

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General NPI Number Information
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    NPI Number           |    1205806676
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    Entity Type          |    Organization 
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    Legal Business Name  |    PALOMAR HEALTH 
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Dates
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    Enumeration Date     |    01/26/2006
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    Last Update Date     |    05/26/2022
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Provider Practice Location Address
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    Address Line         |    120 CRAVEN RD 
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    City                 |    SAN MARCOS
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    State                |    CA
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    Zip                  |    92078-4235
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    Country              |    US
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    Telephone            |    442-281-3800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2125 CITRACADO PKWY STE 300 
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    City                 |    ESCONDIDO
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    State                |    CA
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    Zip                  |    92029-4159
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT AND CEO
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    Name                 |     DIANE  HANSEN 
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    Credential           |    
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    Telephone            |    442-777-0318
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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       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    080000083
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    License Number State |    CA
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