SAN DIEGO DETOX (NPI# 1043768484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043768484 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO DETOX |
| Practice Address |
9480 Pats Point Dr Corona CA 92883-5014 |
| Mailing Address |
Po Box 51310 Los Angeles CA 90051-5610 |
| Practice Telephone | 9513197995 |
| Mailing Telephone | 8552775363 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2017-07-28 |
| Authorized Official Name | MR. JASON MONROE (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6025502211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578084257 | San Diego Detox | Substance Abuse Rehabilitation Facility | 9440 Pats Point Dr, Corona, CA 92883-5014 | 2017-07-03 |
| Street Address |
9480 PATS POINT DR |
| City | CORONA |
| State | CA |
| Zip Code | 92883-5014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922640580 | Daylight Recovery Services, LLC | Substance Abuse Rehabilitation Facility | 9480 Pats Point Dr, Corona, CA 92883-5014 | 2019-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496815 | Onyinye Yvonne Johnson | Nurse Practitioner | 27223 Lasso Way, Corona, CA 92883 | 2017-09-21 |
| 1215376850 | Jennifer Carol Bard | Speech-Language Pathologist | 4194 Floyd Drive, Corona, CA 92883 | 2013-06-17 |
| 1023359619 | Richard Joon Kim | Pharmacist | 4315 Driving Range Rd, Corona, CA 92883 | 2013-03-07 |
| 1740590330 | Kim-thoa Thi Vu | Pharmacist | 2243 Eagle Glen Parkway, Corona, CA 92883 | 2010-10-15 |
| 1114232154 | Always 'tfy' Hospice, Inc. | Hospice Care, Community Based | 9064 Pulsar Court, Ste E, Corona, CA 92883 | 2010-08-14 |
| 1952553844 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 11950 Depalma Rd, Corona, CA 92883 | 2008-10-22 |
| 1497979280 | Sang C Paik Dds | Dentist | 3811 Bedford Canyon Rd, Suite 105, Corona, CA 92883 | 2007-04-12 |
| 1285615864 | Mallory Leon | Family Medicine | 25085 Pacific Crest Street, Corona, CA 92883 | 2005-11-09 |
| 1326038993 | Chan Woo Lee | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2005-10-25 |
| 1659575736 | Optique Optometry, A Professional Corporation | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2007-06-13 |
| Find all providers in zip 92883 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295377570 | Daylight Recovery Services, LLC | Substance Abuse Rehabilitation Facility | 518 Queensland Cir Ste 101, Corona, CA 92879-1381 | 2019-10-08 |
| 1306355144 | Ridgeview Recovery LLC | Substance Abuse Rehabilitation Facility | 1216 Cleveland Way, Corona, CA 92881-5906 | 2017-09-25 |
| 1083136188 | Blvd Centers, Inc. | Substance Abuse Rehabilitation Facility | 518 Queensland Cir, Corona, CA 92879-1381 | 2017-07-10 |
| 1578084257 | San Diego Detox | Substance Abuse Rehabilitation Facility | 9440 Pats Point Dr, Corona, CA 92883-5014 | 2017-07-03 |
| 1265888622 | Casa Contenta Recovery Group, Inc. | Substance Abuse Rehabilitation Facility | 8431 Weirick Rd, Corona, CA 92883-4994 | 2016-05-04 |
| 1225409584 | Reflections Recovery, LLC | Substance Abuse Rehabilitation Facility | 630 Gregory Cir, Corona, CA 92881-3596 | 2015-10-13 |
| 1043698509 | Darlene Leon | Substance Abuse Rehabilitation Facility | 13757 Aspen Leaf Ln, Corona, CA 92880-0721 | 2015-05-15 |
| 1376186718 | Daylight Recovery Services | Substance Abuse Rehabilitation Facility | 9440 Pats Point Dr, Corona, CA 92883-5014 | 2019-10-17 |
| 1922640580 | Daylight Recovery Services, LLC | Substance Abuse Rehabilitation Facility | 9480 Pats Point Dr, Corona, CA 92883-5014 | 2019-10-15 |
| 1174994305 | Elmcor Youth and Adult Activities | Substance Abuse Rehabilitation Facility | 10720 Northern Blvd, Corona, NY 11368-1236 | 2015-10-14 |
| Find all providers in CORONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.