Organization
SENIORS OF SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMELIA PERIALES (DIRECTOR OF PATIENT CARE)
(619) 392-9331
Entity
Organization
Contact information
Practice address
5019 SURFSIDE DR, SAN DIEGO, CA 92154-8449
(619) 207-0057
Mailing address
5019 SURFSIDE DR, SAN DIEGO, CA 92154-8449
(619) 207-0057
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
2010023464
CA
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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