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NPI 1528055787

NPI 1528055787 : POINT LOMA CONVALESCENT HOSPITAL : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1528055787
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    Entity Type          |    Organization 
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    Legal Business Name  |    POINT LOMA CONVALESCENT HOSPITAL 
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Dates
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    Enumeration Date     |    10/03/2005
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    3202 DUKE ST 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92110-5401
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    Country              |    US
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    Telephone            |    619-224-4141
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    Fax                  |    619-224-1328
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Provider Business Mailing Address
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    Address Line         |    3202 DUKE ST 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92110-5401
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    Country              |    US
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    Telephone            |    619-224-4141
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    Fax                  |    619-224-1328
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Authorized Official
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    Title or Position    |    OPERATIONS MANAGER
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    Name                 |     KITTY  TEEL 
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    Credential           |    
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    Telephone            |    619-224-4141
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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 |    CA
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