JGELT CORPORATION NPI 1609920305

NPI Information

JGELT CORPORATION is an adult day care clinic center in San Diego, CA. JGELT CORPORATION NPI is 1609920305. The provider is registered as an organization entity type.
The provider Is Doing Business As Casa Pacifica Adhc Center.

The provider's business location address is:

1424 30TH ST
SUITE C
SAN DIEGO, CA
ZIP 92154-421
Phone: (619) 424-8181
Fax: (619) 424-8151

The provider's authorized official is Luba Vaisman .
The authorized official title is PRESIDENT ADMINISTRATORAdministrator and has the following contact phone number (619) 424-8181.

The CLIA number assigned to this NPI record is 05D0985882 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 8/22/2020.

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:

Other Identifiers

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

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