Pacific Health Care Systems, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

95973 Issued in CA

Legal business name

PACIFIC HEALTH CARE SYSTEMS, INC.

Doing business as

San Diego Homecare Supplies

Practice address

7846 Broadway
Lemon Grove, CA 91945-1801

Phone

(619) 667-3700

Fax

(619) 667-3777

NPI assigned

Dec 2, 2016

Organization subpart

No

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

Authorized official

Name

Sydel Charlier

Title

Director

Phone

(619) 667-3700

Specialties & licenses 2

Addresses

Other names 1

• SAN DIEGO HOMECARE SUPPLIES Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pacific Health Care Systems, Inc.

  dba San Diego Homecare Supplies

  • Prosthetic/Orthotic Supplier
  • San Diego, CA
  • NPI 1265216527

  0042597312

  Same PAC ID

Tax ID family

Pacific Health Care Systems Inc2 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.

• Pacific Health Care Systems, Inc.

  dba San Diego Homecare Supplies

  • Prosthetic/Orthotic Supplier
  • San Diego, CA
  • NPI 1265216527
  NPD tax ID

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1417490889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7846 BROADWAY",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451801",
            "telephone_number": "619-667-3700",
            "fax_number": "619-667-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7846 BROADWAY",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451801",
            "telephone_number": "619-667-3700",
            "fax_number": "619-667-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEALTH CARE SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-02",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "CHARLIER",
        "authorized_official_first_name": "SYDEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-667-3700"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "95973",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "95973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN DIEGO HOMECARE SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAN DIEGO HOMECARE SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Logan Osuna
• Christa Diane Overton
• Russell Owens
• PA Enterprises, Inc.
• Andrea Alejandra Pacheco
• Pacifica Monte Vista LLC (Monte Vista Village Senior Living)
• Janet Parat, MSW, PPSC
• Paul J.Wesling, O.D., Inc. (Lemon Grove Optometry)
• Peerless Medical Billing and Credentialing LLC
• Fredrick Richardo Perez

• Prosthetic/Orthotic Supplier in Lemon Grove, CA
• Providers in Lemon Grove, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.