DAISY RUTH POMILIA NPI 1770756546

NPI Information

NPI: 1770756546
Provider Name: DAISY RUTH POMILIA
Classification: Clinic/Center - 261QR0405X
Entity Type: Individual

Specialization: Rehabilitation, Substance Use Disorder

Address:
6154 MISSION GORGE RD
120
SAN DIEGO, CA
ZIP 92120
Phone: (619) 285-1718
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Daisy Ruth Pomilia is a rehabilitation and substance use disorder clinic center in San Diego, CA. Daisy Ruth Pomilia NPI is 1770756546. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6154 MISSION GORGE RD
120
SAN DIEGO, CA
ZIP 92120-493
Phone: (619) 285-1718

The enumeration date for this NPI number is 4/11/2008 and was last updated on 4/11/2008.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	370069MN	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	37AL	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: 4/28/2024

NPI Synchronization or Removal

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