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General NPI Number Information
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NPI Number | 1629207287
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Entity Type | Organization
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Legal Business Name | ABC HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 07/04/2009
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 5090 SHOREHAM PL STE 109
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City | SAN DIEGO
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State | CA
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Zip | 92122-5934
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Country | US
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Telephone | 858-455-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3636 NOBEL DR STE 450
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City | SAN DIEGO
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State | CA
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Zip | 92122-1062
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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 | CEO
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Name | JEFF MONGONIA
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Credential |
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Telephone | 858-251-4242
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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 | CA
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