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SPECTRUM ADULT DAY HEALTH SERVICES INC NPI 1396201828


NPI Information

NPI: 1396201828
Provider Name: SPECTRUM ADULT DAY HEALTH SERVICES INC

Doing Business As: SAN DIEGO FAMILY CIRCLE ADULT DAY HEALTH CARE

Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

Address:
4428 CONVOY ST STE 288
SAN DIEGO, CA
ZIP 92111
Phone: (802) 430-7543
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SPECTRUM ADULT DAY HEALTH SERVICES INC is an adult day care clinic center in San Diego, CA. SPECTRUM ADULT DAY HEALTH SERVICES INC NPI is 1396201828. The provider is registered as an organization entity type.
The provider Is Doing Business As San Diego Family Circle Adult Day Health Care.

The provider's business location address is:

4428 CONVOY ST STE 288
SAN DIEGO, CA
ZIP 92111-761
Phone: (802) 430-7543
Fax: (856) 724-3302

The provider's authorized official is Gary Polsky .
The authorized official title is Owner and has the following contact phone number (858) 952-8531.

The enumeration date for this NPI number is 2/20/2019 and was last updated on 11/1/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA0600XClinic/CenterAdult Day CareYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11396201828MEDICAIDCALIFORNIA

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: 4/28/2024

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