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NPI 1417321100ActiveOrganization· PACE Provider Organization· Chula Vista, CA
PACE Provider Organization in Chula Vista, California, registered in NPPES in November 2015. The authorized official on file is Shannon Davis, Physical Therapist.
Overview
| NPI | 1417321100 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 18, 2015 |
| Last updated in NPPES | Nov 18, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X | 9559 | CA |
| Day Training, Developmentally Disabled Services | 251C00000X | 9559 | CA |
| Assisted Living Facility | 310400000X | 9559 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other PACE Provider Organization providers in Chula Vista
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- 1497676985