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NPI Code Detail

MEDICARE: INTERIM HEALTHCARE SAN DIEGO LLC

MEDICARE: INTERIM HEALTHCARE SAN DIEGO LLC
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
1251E00000XHome Health Agency080000395CA

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 : 1093750747
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERIM HEALTHCARE SAN DIEGO LLC
Provider Business Mailing Address
First Line : 425 W 5TH AVE
Second Line : SUITE 101
City : ESCONDIDO
State : CA
Zip : 92025-4843
Country : US
Telephone Number : 760-432-9811
Fax Number : 760-739-1366
Provider Business Practice Location Address
First Line : 425 W 5TH AVE
Second Line : SUITE 101
City : ESCONDIDO
State : CA
Zip : 92025-4843
Country : US
Telephone Number : 760-432-9811
Fax Number : 760-739-1366
Authorized Official
Title or Position : GENERAL COUNSEL CHIEF COMPLIANCE OF
Name : PATRICIA MARY MCGILLAN
Credential :
Telephone Number : 301-956-5087
Provider Enumeration Date : 06/17/2006
Last Update Date : 10/17/2023

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Directions to “INTERIM HEALTHCARE SAN DIEGO LLC ” Practice Location

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