Organization
POMERADO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VALERIE CANDELARIA (ACCOUNTS RECEIVABLE SUPERVISOR)
(909) 446-8754
Entity
Organization
Contact information
Practice address
12696 MONTE VISTA RD, POWAY, CA 92064-2500
(858) 487-6242
(858) 487-4282
Mailing address
12696 MONTE VISTA RD, POWAY, CA 92064-2500
(858) 487-6242
(858) 487-4282
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
555206
MEDICARE PROVIDER NUMBER
CA
05
—
LTC55206H
—
CA
Enumeration date
07/02/2007
Last updated
07/16/2007
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