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NPI Code Detail

MEDICARE: ADVANCED HOME HEALTH SAN DIEGO INC

MEDICARE: ADVANCED HOME HEALTH SAN DIEGO 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
1251E00000XHome Health Agency550001206CA

General Provider Information

NPI Number : 1649669938
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED HOME HEALTH SAN DIEGO INC
Provider Business Mailing Address
First Line : 9245 ACTIVITY RD STE 210
Second Line :
City : SAN DIEGO
State : CA
Zip : 92126-4442
Country : US
Telephone Number : 858-673-8880
Fax Number : 858-673-8881
Provider Business Practice Location Address
First Line : 9245 ACTIVITY RD STE 210
Second Line :
City : SAN DIEGO
State : CA
Zip : 92126-4442
Country : US
Telephone Number : 858-673-8880
Fax Number :
Authorized Official
Title or Position : PRESIDENT OF OPERATIONS
Name : KRISTI HALVA
Credential :
Telephone Number : 858-673-8880
Provider Enumeration Date : 01/09/2015
Last Update Date : 10/06/2022

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