My New Home Corp.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MY NEW HOME CORP.

Doing business as

My New Home - Lodi Gardens

Practice address

5289 Lodi St
San Diego, CA 92117-1152

Phone

(858) 272-5286

Fax

(858) 272-2571

NPI assigned

Aug 12, 2022

Last updated

Aug 12, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MY NEW HOME CORP.As reported in NPPES

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

Authorized official

Name

Diep Malmberg

Title

Ceo

Phone

(858) 272-5286

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MY NEW HOME - LODI GARDENS Doing business as

Part of

My New Home Corp

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1952039240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5289 LODI ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171152",
            "telephone_number": "858-272-5286",
            "fax_number": "858-272-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5289 LODI ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171152",
            "telephone_number": "858-272-5286",
            "fax_number": "858-272-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY NEW HOME CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY NEW HOME CORP.",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "MALMBERG",
        "authorized_official_first_name": "DIEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-272-5286"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "374604584",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MY NEW HOME - LODI GARDENS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in San Diego, CA
• Providers in San Diego, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.