Provider Demographics
NPI:1295503068
Name:SUNSET COAST 3 CORP
Entity type:Organization
Organization Name:SUNSET COAST 3 CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-481-4862
Mailing Address - Street 1:2285 INGRID AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-3061
Mailing Address - Country:US
Mailing Address - Phone:619-352-7964
Mailing Address - Fax:
Practice Address - Street 1:4886 DOLIVA DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3210
Practice Address - Country:US
Practice Address - Phone:619-481-4862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility