Organization Active NPI

Yealem LLC Dba Mission Villa East, Mission Villa West

  • PACE Provider Organization
  • San Diego, CA
National Provider Identifier
1114864055
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
YEALEM LLC DBA MISSION VILLA EAST, MISSION VILLA WEST
Practice address
7241 Zest St
San Diego, CA 92139-1253
Phone
(619) 757-9519
Fax
(619) 757-9519
NPI assigned
Apr 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Amsal Engdaw
Title
Managing Member
Phone
(619) 757-9519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

7241 Zest St
San Diego, CA 92139-1253

Mailing address

7241 Zest St
San Diego, CA 92139-1253
Phone (619) 757-9519

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1114864055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7241 ZEST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921391253",
            "telephone_number": "619-757-9519",
            "fax_number": "619-757-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 ZEST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921391253",
            "telephone_number": "619-757-9519",
            "fax_number": "619-757-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YEALEM LLC DBA MISSION VILLA EAST, MISSION VILLA WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "ENGDAW",
        "authorized_official_first_name": "AMSAL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "619-757-9519"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.