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General NPI Number Information
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NPI Number | 1710567102
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Entity Type | Organization
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Legal Business Name | RANCHO DIGIUS LLC
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Dates
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Enumeration Date | 04/10/2021
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Last Update Date | 04/10/2021
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Provider Practice Location Address
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Address Line | 2445 BROADWAY
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City | SAN DIEGO
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State | CA
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Zip | 92102-2021
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Country | US
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Telephone | 619-468-5700
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Fax | 619-468-5701
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Provider Business Mailing Address
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Address Line | 2710 VIA DE LA VALLE STE B280
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City | DEL MAR
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State | CA
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Zip | 92014-1935
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Country | US
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Telephone | 858-717-0346
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZAHRA DIGIUS
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Credential |
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Telephone | 858-717-0346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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