Organization
COMMUNITY ELDERCARE SAN DIEGO
Active
Other names
St. Paul's PACE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA JOY GOIS (MARKETING DIRECTOR)
(619) 677-3800
Entity
Organization
Contact information
Practice address
111 ELM ST, SAN DIEGO, CA 92101-2692
(619) 677-3800
(619) 781-8186
Mailing address
111 ELM ST, SAN DIEGO, CA 92101-2692
(619) 677-3800
(619) 781-8186
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
550001964
CA
305R00000X
Preferred Provider Organization
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057
—
CA
Enumeration date
04/02/2013
Last updated
04/02/2013
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