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General NPI Number Information
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NPI Number | 1699169953
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Entity Type | Organization
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Legal Business Name | CORDOBA CARE
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 9920 PACIFIC HEIGHTS BLVD SUITE 150
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City | SAN DIEGO
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State | CA
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Zip | 92121-4396
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Country | US
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Telephone | 858-413-7880
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Fax |
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Provider Business Mailing Address
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Address Line | 9920 PACIFIC HEIGHTS BLVD SUITE 150
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City | SAN DIEGO
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State | CA
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Zip | 92121-4396
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Country | US
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Telephone | 858-413-7880
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. REEWA NAZZAL
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Credential |
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Telephone | 858-413-7880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 3751418
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | CA
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