# COUNTY OF SAN DIEGO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** EDGEMOOR HOSPITAL DPSNF
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962556290
- **Authorized official:** MR. WALTER HEKIMIAN (ADMINISTRATOR)
- **Authorized official phone:** (619) 596-5597

## Contact information

- **Practice address:** 655 PARK CENTER DR, SANTEE, CA 92071-6957
- **Practice address phone:** (619) 596-5500
- **Practice address fax:** (619) 596-5584
- **Mailing address:** 655 PARK CENTER DR, SANTEE, CA 92071-6957
- **Mailing address phone:** (619) 596-5500
- **Mailing address fax:** (619) 596-5584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 04/29/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05008F | — | CA |