NPIMap

Organization Active NPI

Sea Coast Home Health Care Inc

  • Home Health Agency
  • San Diego, CA
National Provider Identifier
1720523921
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SEA COAST HOME HEALTH CARE INC
Practice address
8380 Miramar Mall
Ste 107
San Diego, CA 92121-2548
Phone
(858) 452-9200
Fax
(858) 452-7300
NPI assigned
Dec 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Mr. Elmer Solis
Title
Executive Director
Phone
(858) 452-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

8380 Miramar Mall
Ste 107
San Diego, CA 92121-2548

Mailing address

8380 Miramar Mall
Ste 107
San Diego, CA 92121-2548
Phone (858) 452-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180710001118 CA Part A Provider - Home Health Agency 0446506240 Practice locations: San Diego, CA

Home health agency certification: CCN 559055

Legal name
SEA COAST HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 3, 2019
Last certification
Jul 3, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 9, 2016 in CA
Enrollment address
8380 Miramar Mall
Ste 107
San Diego, CA 92121-2549

Care Compare: Home health agency

Medicare Care Compare
Listed as
Sea Coast Home Health Care IncCCN 559055
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jul 3, 2019
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

8380 Miramar Mall
Ste 107
San Diego, CA 92121
Phone (858) 452-9200

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Suzanna Gavranian Individual 5% Or Greater Direct Ownership InterestOwner Dec 9, 2016 100%
Corporate OfficerPresident/Trasurer Dec 9, 2016 100%
Corporate DirectorBoard Director Dec 9, 2016 100%
W-2 Managing EmployeePresident Dec 9, 2016 100%
Operational/Managerial ControlPresident/Trasurer Dec 9, 2016 100%
Samson Gavranian Individual Corporate OfficerBoard Secretary Dec 9, 2016
Corporate DirectorBoard Director Dec 9, 2016
W-2 Managing EmployeeBoard Secretary Dec 9, 2016
Operational/Managerial ControlBoard Secretary Dec 9, 2016

Practitioners & affiliated clinicians

Affiliated clinicians 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1720523921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 MIRAMAR MALL",
            "address_2": "STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212548",
            "telephone_number": "858-452-9200",
            "fax_number": "858-452-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 MIRAMAR MALL",
            "address_2": "STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212548",
            "telephone_number": "858-452-9200",
            "fax_number": "858-452-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA COAST HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-23",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "SOLIS",
        "authorized_official_first_name": "ELMER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "858-452-9200",
        "authorized_official_name_prefix": "Mr."
    },
    "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.