MEDICARE: ADVANTAGE HEALTH SYSTEMS

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	251E00000X	Home Health Agency	550000163	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	550000163	OTHER	CA	CDPH LICENSE

General Provider Information

NPI Number	:	1538225313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE HEALTH SYSTEMS

Provider Business Mailing Address
First Line	:	9663 TIERRA GRANDE ST
Second Line	:	SUITE #101
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4569
Country	:	US
Telephone Number	:	858-433-0469
Fax Number	:	858-433-0479

Provider Business Practice Location Address
First Line	:	9663 TIERRA GRANDE ST
Second Line	:	SUITE #101
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4569
Country	:	US
Telephone Number	:	858-433-0469
Fax Number	:	858-433-0479

Authorized Official
Title or Position	:	CEO
Name	:	EMIL BUNDANG
Credential	:
Telephone Number	:	858-433-0469

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	10/31/2018

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Directions to “ADVANTAGE HEALTH SYSTEMS ” Practice Location

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