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General NPI Number Information
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NPI Number | 1467657064
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Entity Type | Organization
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Legal Business Name | COUNTY OF SAN DIEGO
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9065 EDEGMOOR DRIVE
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City | SANTEE
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State | CA
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Zip | 92071
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Country | US
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Telephone | 619-956-2955
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Fax |
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Provider Business Mailing Address
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Address Line | 12025 CALLE DE LEON APT 13
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City | EL CAJON
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State | CA
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Zip | 92019-4900
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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 | RN - STAFF NURSE 2
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Name | MS. DELORES JOAN LEONARD
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Credential |
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Telephone | 619-670-1523
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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 | 376421
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License Number State | CA
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