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General NPI Number Information
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NPI Number | 1275946568
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Entity Type | Organization
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Legal Business Name | GHC OF KEARNY MESA, LLC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 7675 FAMILY CIR
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City | SAN DIEGO
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State | CA
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Zip | 92111-5304
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Country | US
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Telephone | 858-278-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 7675 FAMILY CIR
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City | SAN DIEGO
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State | CA
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Zip | 92111-5304
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Country | US
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Telephone | 858-278-8121
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | LOIS MASTROCOLA
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Credential |
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Telephone | 714-241-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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