Organization
TELECARE AGE WISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KIM MAI BA, SOCIOLOGY (PERSONAL SERVICE COORDINATOR II)
(619) 481-5200
Entity
Organization
Contact information
Practice address
6160 MISSION GORGE RD STE 108, SAN DIEGO, CA 92120-3425
(619) 481-5200
Mailing address
6160 MISSION GORGE RD STE 108, SAN DIEGO, CA 92120-3425
(619) 481-5200
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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