Provider Demographics
NPI:1386014314
Name:SUN ANGEL HEALTH, INC.
Entity Type:Organization
Organization Name:SUN ANGEL HEALTH, INC.
Other - Org Name:COMFORCARE HOME CARE SAN DIEGO LA JOLLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-846-8008
Mailing Address - Street 1:4901 MORENA BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3423
Mailing Address - Country:US
Mailing Address - Phone:858-270-1700
Mailing Address - Fax:858-270-1717
Practice Address - Street 1:4901 MORENA BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3423
Practice Address - Country:US
Practice Address - Phone:858-270-1700
Practice Address - Fax:858-270-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care