Organization
LA COSTA RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RESTITUTO LUMBA CALILUNG (ADMINISTRATOR)
(714) 906-6046
Entity
Organization
Contact information
Practice address
3016 BUCHANAN WAY, COSTA MESA, CA 92626-2834
(714) 906-6046
Mailing address
3016 BUCHANAN WAY, COSTA MESA, CA 92626-2834
(714) 906-6046
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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