MEDICARE: VALLEY VIEW SANITARIUM & REST HOME

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
1	313M00000X	Nursing Facility/Intermediate Care Facility		CA

Other Identifiers

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

General Provider Information

NPI Number	:	1528250024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VIEW SANITARIUM & REST HOME

Provider Business Mailing Address
First Line	:	PO BOX 90
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91951-0090
Country	:	US
Telephone Number	:	619-267-8400
Fax Number	:	619-267-0892

Provider Business Practice Location Address
First Line	:	1384 FRAULINE DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-2922
Country	:	US
Telephone Number	:	619-575-2824
Fax Number	:	619-575-7275

Authorized Official
Title or Position	:	EXECUTIVE ADMINISTRATOR
Name	:	MRS. JUANITA RETTINGHAUS
Credential	:
Telephone Number	:	619-267-8400

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	08/17/2007

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