Community Eldercare San Diego

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

550001964 Issued in CA

Legal business name

COMMUNITY ELDERCARE SAN DIEGO

Practice address

111 Elm St
San Diego, CA 92101-2692

Phone

(619) 677-3800

Fax

(619) 781-8186

NPI assigned

Apr 2, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Amanda Joy Gois

Title

Marketing Director

Phone

(619) 677-3800

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• St. Paul's PACE Doing business as

Tax ID family

Community Eldercare of San Diego2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Community Eldercare of San Diego

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1841476967
  NPD tax ID

Locations

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1386987915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012692",
            "telephone_number": "619-677-3800",
            "fax_number": "619-781-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012692",
            "telephone_number": "619-677-3800",
            "fax_number": "619-781-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ELDERCARE SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "GOIS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "MARKETING DIRECTOR",
        "authorized_official_telephone_number": "619-677-3800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "550001964",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Paul's PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Community Catalysts of California
• Community Dental Services
• Community Dental Services
• Community Dental Services
• Community Eldercare of San Diego
• Community Health and Immunization Services, LLC
• Community Health Imaging Centers
• Community in Home Care
• Community Prescription Center
• Community Research Fgoundation

• Community Health Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.