COMMUNITY ELDERCARE SAN DIEGO NPI 1386987915

NPI Information

NPI: 1386987915
Provider Name: COMMUNITY ELDERCARE SAN DIEGO
Classification: Clinic/Center - 261QC1500X
Specialization: Community Health
Entity Type: Organization
Doing Business As: ST. PAUL'S PACE
CLIA Number: 05D1075714
Address: 111 ELM ST
SAN DIEGO, CA
ZIP 92101
Phone: (619) 677-3800

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NPI Details

COMMUNITY ELDERCARE SAN DIEGO is a community health clinic center in San Diego, CA. COMMUNITY ELDERCARE SAN DIEGO NPI is 1386987915. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Paul's Pace.

The provider's business location address is:

111 ELM ST
SAN DIEGO, CA
ZIP 92101-692
Phone: (619) 677-3800
Fax: (619) 781-8186

The provider's authorized official is Amanda Joy Gois .
The authorized official title is Marketing Director and has the following contact phone number (619) 677-3800.

The CLIA number assigned to this NPI record is 05D1075714 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2013 and was last updated on 4/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	305R00000X	Preferred Provider Organization			CALIFORNIA	No
2	261QC1500X	Clinic/Center	Community Health	550001964	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H5629	MEDICARE PIN	CALIFORNIA
2	057	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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