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NPI Code Detail

MEDICARE: BERNARDO HEIGHTS HEALTHCARE, INC.

MEDICARE: BERNARDO HEIGHTS HEALTHCARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility080000315CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083727093
Entity Type Code : Organization
Provider Name (Legal Business Name) : BERNARDO HEIGHTS HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 11895 AVENUE OF INDUSTRY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-3423
Country : US
Telephone Number : 858-673-0101
Fax Number : 858-673-8320
Provider Business Practice Location Address
First Line : 11895 AVENUE OF INDUSTRY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-3423
Country : US
Telephone Number : 858-673-0101
Fax Number : 858-673-8320
Authorized Official
Title or Position : TREASURER
Name : SOON BURNAM
Credential :
Telephone Number : 949-540-1249
Provider Enumeration Date : 08/16/2006
Last Update Date : 02/17/2021

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