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NPI Code Detail

MEDICARE: SD HOMECARE SERVICES

MEDICARE: SD HOMECARE SERVICES
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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1740022581
Entity Type Code : Organization
Provider Name (Legal Business Name) : SD HOMECARE SERVICES
Provider Business Mailing Address
First Line : 16136 PASEO DEL SUR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92127-6155
Country : US
Telephone Number : 858-899-0023
Fax Number :
Provider Business Practice Location Address
First Line : 10085 CARROLL CANYON RD STE 260
Second Line :
City : SAN DIEGO
State : CA
Zip : 92131-1138
Country : US
Telephone Number : 858-707-7599
Fax Number : 858-703-1078
Authorized Official
Title or Position : PRESIDENT
Name : GREG ENRIQUE
Credential :
Telephone Number : 858-707-7599
Provider Enumeration Date : 06/12/2024
Last Update Date : 06/12/2024

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Directions to “SD HOMECARE SERVICES ” Practice Location

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