Provider Demographics
NPI:1952449050
Name:UCSD EATING DISORDER TREATMENT AND RESEARCH CENTER
Entity Type:Organization
Organization Name:UCSD EATING DISORDER TREATMENT AND RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-534-2358
Mailing Address - Street 1:4510 EXECUTIVE DR
Mailing Address - Street 2:#315
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3021
Mailing Address - Country:US
Mailing Address - Phone:858-534-8019
Mailing Address - Fax:858-534-6727
Practice Address - Street 1:4510 EXECUTIVE DR
Practice Address - Street 2:#315
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3021
Practice Address - Country:US
Practice Address - Phone:858-534-8019
Practice Address - Fax:858-534-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health