Organization Active NPI

Point Loma Convalescent Hospital

  • Skilled Nursing Facility
  • San Diego, CA
National Provider Identifier
1528055787
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
POINT LOMA CONVALESCENT HOSPITAL
Practice address
3202 Duke St
San Diego, CA 92110-5401
Phone
(619) 224-4141
Fax
(619) 224-1328
NPI assigned
Oct 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kitty Teel
Title
Operations Manager
Phone
(619) 224-4141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

3202 Duke St
San Diego, CA 92110-5401

Mailing address

3202 Duke St
San Diego, CA 92110-5401
Phone (619) 224-4141

Other identifiers 2

IdentifierTypeStateIssuer
ZZTO5322HMedicaidCA
4365879-8OtherCASTATE TAX I.D.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528055787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 DUKE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105401",
            "telephone_number": "619-224-4141",
            "fax_number": "619-224-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 DUKE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105401",
            "telephone_number": "619-224-4141",
            "fax_number": "619-224-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POINT LOMA CONVALESCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TEEL",
        "authorized_official_first_name": "KITTY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "619-224-4141"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZTO5322H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX I.D.",
            "identifier": "4365879-8",
            "state": "CA"
        }
    ],
    "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 Aug 22, 2020; 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.