Provider Demographics
NPI: | 1508968751 |
---|---|
Name: | REGENTS OF THE UNIVERSITY OF CALIFORNIA |
Entity Type: | Organization |
Organization Name: | REGENTS OF THE UNIVERSITY OF CALIFORNIA |
Other - Org Name: | UCSD MEDICAL GROUP |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | DIRECTOR, REVENUE CYCLE & OPERATION |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | DENNIS |
Authorized Official - Last Name: | PRICE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 858-249-6752 |
Mailing Address - Street 1: | FILE 57326 |
Mailing Address - Street 2: | |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90074-2410 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-926-8273 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 200 W ARBOR DR |
Practice Address - Street 2: | |
Practice Address - City: | SAN DIEGO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92103-9000 |
Practice Address - Country: | US |
Practice Address - Phone: | 800-926-8273 |
Practice Address - Fax: | 888-539-8781 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-09-01 |
Last Update Date: | 2024-04-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0008X | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 2327 | Other | CMS |
CA | ZZZP3708Z | Medicaid | |
364823301 | Other | US DEPT OF LABOR | |
CA | 71 | Other | RYAN WHITE |
CA | GR0013562 | Medicaid | |
364823302 | Other | US DEPT OF LABOR | |
CA | CGP016905 | Other | GHPP |
CA | 364823310 | Other | US DEPT OF LABOR |
CA | CQ4024 | Other | RAILROAD MEDICARE |
CA | ZZZP3708Z | Other | BLUE SHIELD |
CA | ZZZP3708Z | Other | BLUE SHIELD |
CA | GR0013562 | Medicaid | |
CA | W324F | Medicare PIN | |
CA | CQ4024 | Other | RAILROAD MEDICARE |
CA | W324E | Medicare PIN | |
CA | HW324 | Medicare PIN | |
CA | ZZZP3708Z | Other | BLUE SHIELD |
CA | W324C | Medicare PIN |