Provider Demographics
NPI:1578556114
Name:SCRIPPS HEALTH
Entity Type:Organization
Organization Name:SCRIPPS HEALTH
Other - Org Name:SCRIPPS HOME HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP. EXECUTIVE VP
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-678-6828
Mailing Address - Street 1:9619 CHESAPEAKE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1368
Mailing Address - Country:US
Mailing Address - Phone:858-715-7300
Mailing Address - Fax:858-715-7419
Practice Address - Street 1:9619 CHESAPEAKE DRIVE
Practice Address - Street 2:STE 300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-715-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07529FMedicaid
CAHHA07529FMedicaid