MEDICARE: POINT LOMA REHABILITATION CENTER, 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
1	314000000X	Skilled Nursing Facility	090000088	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538174990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POINT LOMA REHABILITATION CENTER, LLC

Provider Business Mailing Address
First Line	:	3202 DUKE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-5401
Country	:	US
Telephone Number	:	619-224-4141
Fax Number	:	619-224-1309

Provider Business Practice Location Address
First Line	:	3202 DUKE ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110
Country	:	US
Telephone Number	:	619-224-4141
Fax Number	:	619-224-1309

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. SHLOMO RECHNITZ
Credential	:
Telephone Number	:	626-800-1191

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	10/19/2022

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