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General NPI Number Information
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NPI Number | 1700295185
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Entity Type | Organization
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Legal Business Name | SUMAD LLC
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 9606 TIERRA GRANDE STR. 201
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City | SAN DIEGO
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State | CA
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Zip | 92126-6501
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Country | US
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Telephone | 760-672-0757
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Fax |
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Provider Business Mailing Address
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Address Line | 593 VIA DEL CABALLO
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City | SAN MARCOS
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State | CA
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Zip | 92078
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Country | US
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Telephone | 760-672-0757
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD A TAHIRY
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Credential |
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Telephone | 858-777-9525
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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 |
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