Avantgarde Senior Living of la Jolla

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AVANTGARDE SENIOR LIVING OF LA JOLLA

Practice address

6211 La Jolla Hermosa Ave
La Jolla, CA 92037-6736

Phone

(858) 456-8619

Fax

(818) 881-0180

NPI assigned

Nov 30, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jason Adelman

Title

President/ Ceo

Phone

(818) 692-5284

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1013675719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ABBOT KINNEY BLVD",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913741",
            "telephone_number": "818-692-5284",
            "fax_number": "818-881-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 LA JOLLA HERMOSA AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920376736",
            "telephone_number": "858-456-8619",
            "fax_number": "818-881-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTGARDE SENIOR LIVING OF LA JOLLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "ADELMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "818-692-5284"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RCFE FACILITY LICENSE",
            "identifier": "374604261",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Patrick Austin, M.D.
• Johana Austria, FNP
• Iman Amira Autman
• Tammy Auyeung, PA-C
• Alex B Avanessian, D.D.S.
• Bryan Stephen Avilez
• Ayman Naser DDS Inc (The Shores Dental)
• Azadeh Shirazi MD Inc (La Jolla Dermatology & Laser Surgery Center)
• Paricheh Azimi, PHARMD
• Tamara Azoulay

• Assisted Living Facility in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.