Provider Demographics
NPI:1083797450
Name:MGV HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:MGV HEALTH SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOPCS
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAZEL ANN
Authorized Official - Middle Name:ASUNCION
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:858-573-6837
Mailing Address - Street 1:3944 MURPHY CANYON RD STE C202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4427
Mailing Address - Country:US
Mailing Address - Phone:858-573-6837
Mailing Address - Fax:858-573-8917
Practice Address - Street 1:3944 MURPHY CANYON RD
Practice Address - Street 2:C-202
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4498
Practice Address - Country:US
Practice Address - Phone:858-573-6837
Practice Address - Fax:858-373-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA058091251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health