Alvarado Hospital, LLC

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

Legal business name

ALVARADO HOSPITAL, LLC

Practice address

6645 Alvarado Rd
San Diego, CA 92120-5208

Phone

(619) 229-3172

Fax

(619) 229-3273

NPI assigned

Jun 25, 2006

Last updated

Oct 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Harris Koenig

Title

Ceo

Phone

(619) 229-3172

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alvarado Hospital Rehab Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962438200. Details of each certification follow.

• CCN 053030 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 053030

Legal name

ALVARADO HOSPITAL MEDICAL CENTER/SDRI

Certification status

Terminated Voluntary: merger or closure, Jun 1, 2000

Provider type (POS)

Hospital – Rehabilitation

Participating since

Jun 14, 1990

Last certification

Jun 14, 1990

Beds

80 (50 certified)

Ownership / control type

Private (for profit)

Most recent change of ownership

Jun 1, 2000 (1 total)

Facility address

6645 Alvarado Road
San Diego, CA 92120

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1962438200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6645 ALVARADO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205208",
            "telephone_number": "619-229-3172",
            "fax_number": "619-229-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6645 ALVARADO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205208",
            "telephone_number": "619-229-3172",
            "fax_number": "619-229-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVARADO HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-229-3172",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "ZZZC3721Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alvarado Hospital Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Rehabilitation Hospital Unit in San Diego, CA
• Providers in San Diego, CA by specialty
• Rehabilitation Hospital Unit in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.