NPIMap

Organization Active NPI

Guardian Angel Home Care of San Diego LLC

  • Home Health Agency
  • San Diego, CA
National Provider Identifier
1356987085
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GUARDIAN ANGEL HOME CARE OF SAN DIEGO LLC
Practice address
3505 Camino del Rio S Ste 220
San Diego, CA 92108-4016
Phone
(619) 640-4383
Fax
(619) 640-4385
NPI assigned
Nov 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Sam D Kassab
Title
Ceo/Owner
Phone
(248) 293-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3505 Camino del Rio S Ste 220
San Diego, CA 92108-4016

Mailing address

1715 Northfield Dr
Rochester Hills, MI 48309-3819
Phone (248) 293-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200526001864 CA Part A Provider - Home Health Agency 3476974692 Practice locations: San Diego, CA

Home health agency certification: CCN 058457

Legal name
GUARDIAN ANGEL HOME CARE OF SAN DIEGO
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 6, 2008
Last certification
Aug 23, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
3505 Camino del Rio S
Ste 220
San Diego, CA 92108-4016

Care Compare: Home health agency

Medicare Care Compare
Listed as
Guardian Angel Home Care of San Diego LLCCCN 058457
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Mar 6, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

3505 Camino del Rio S
Ste 220
San Diego, CA 92108
Phone (619) 640-4383

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Guardian Angel Home Care Inc Organization, Rochester Hills, MI Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2020 100%
Gerald Kustra Individual Corporate DirectorBoard Member Apr 1, 2020
Faye Kassab Individual Corporate DirectorBoard Member Apr 1, 2020
Guardian Angel Home Care of Southern California Organization, Rochester Hills, MI LLC, For-profit 5% Or Greater Direct Ownership Interest Apr 1, 2020 100%
Sam D Kassab Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2020 100%
Corporate OfficerCeo/Director Apr 1, 2020
Corporate DirectorCeo/Director Apr 1, 2020
Operational/Managerial ControlCeo/Director Apr 1, 2020
Susan Freilino Individual W-2 Managing EmployeeAdministrator Apr 1, 2020
Operational/Managerial ControlAdministrator Apr 1, 2020

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1356987085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 NORTHFIELD DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093819",
            "telephone_number": "248-293-2400",
            "fax_number": "248-293-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 CAMINO DEL RIO S STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084016",
            "telephone_number": "619-640-4383",
            "fax_number": "619-640-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL HOME CARE OF SAN DIEGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "248-293-2400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.