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NPI Code Detail

MEDICARE: ST. PAUL'S EPISCOPAL HOME, INC.

MEDICARE: ST. PAUL'S EPISCOPAL HOME, 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
1314000000XSkilled Nursing Facility090000181CA

Other Identifiers

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

General Provider Information

NPI Number : 1972619104
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. PAUL'S EPISCOPAL HOME, INC.
Provider Business Mailing Address
First Line : 328 MAPLE ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-6522
Country : US
Telephone Number : 619-239-6900
Fax Number : 619-239-1256
Provider Business Practice Location Address
First Line : 235 NUTMEG ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-6201
Country : US
Telephone Number : 619-239-8687
Fax Number : 619-239-1201
Authorized Official
Title or Position : SENIOR ACCOUNTING MANAGER
Name : SHEILAH MOLINA
Credential :
Telephone Number : 619-239-6900
Provider Enumeration Date : 08/21/2006
Last Update Date : 11/26/2024

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