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General NPI Number Information
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NPI Number | 1689531832
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Entity Type | Organization
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Legal Business Name | EASY LIVING @ MIRA MESA
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 10136 ZAPATA AVE
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City | SAN DIEGO
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State | CA
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Zip | 92126-1124
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Country | US
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Telephone | 858-663-2425
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Fax | 858-430-5555
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Provider Business Mailing Address
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Address Line | 10136 ZAPATA AVE
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City | SAN DIEGO
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State | CA
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Zip | 92126-1124
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Country | US
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Telephone | 858-663-2425
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Fax | 858-430-5555
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Authorized Official
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Title or Position | LICENSEE ADMINISTRATOR CAREGIVER
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Name | MR. DANILO CASINTAHAN CALCETAS
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Credential | LICENSEE
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Telephone | 858-663-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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