Provider Demographics
NPI:1467834085
Name:VISTA DEL SOL HEALTH SERVICES INC
Entity Type:Organization
Organization Name:VISTA DEL SOL HEALTH SERVICES INC
Other - Org Name:CASA DEL MAR IV - RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:PREIMESBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-390-9045
Mailing Address - Street 1:11620 W WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5916
Mailing Address - Country:US
Mailing Address - Phone:310-390-9045
Mailing Address - Fax:310-391-7677
Practice Address - Street 1:4323 COOLIDGE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5905
Practice Address - Country:US
Practice Address - Phone:310-390-9045
Practice Address - Fax:310-391-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191601231310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility