Provider Demographics
NPI:1003854688
Name:SCRIPPS HEALTH
Entity Type:Organization
Organization Name:SCRIPPS HEALTH
Other - Org Name:SCRIPPS MEMORIAL HOSPITAL ENCINITAS REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHERBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-678-6828
Mailing Address - Street 1:10790 RANCHO BERNARDO RD.
Mailing Address - Street 2:3RD FL.
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:760-753-6501
Mailing Address - Fax:858-964-3110
Practice Address - Street 1:354 SANTA FE DR
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5142
Practice Address - Country:US
Practice Address - Phone:760-753-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCRIPPS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA08-0000148273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT 40503GMedicaid
CA6050660OtherAETNA
CAHSC 30503GOtherMCL HMO IN-PATIENT
CASMENOtherUNIVERSAL CARE
CAZZT 40503GOtherMCL HMO OUT-PATIENT
CAZZZD0503ZOtherBLUE SHIELD
CA26OtherKAISER
CAHCS 30503GMedicaid
CA05 0503OtherBLUE CROSS
CAZZT 30503GMedicaid
CA6050660OtherAETNA