Provider Demographics
NPI:1508813080
Name:SCRIPPS HEALTH DOING BUSINESS AS SCRIPPS MRI CENTER AT ENCINITAS
Entity Type:Organization
Organization Name:SCRIPPS HEALTH DOING BUSINESS AS SCRIPPS MRI CENTER AT ENCINITAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-633-7699
Mailing Address - Street 1:354 SANTA FE DR
Mailing Address - Street 2:MAILDROP ENC12
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5142
Mailing Address - Country:US
Mailing Address - Phone:760-633-6601
Mailing Address - Fax:760-633-7356
Practice Address - Street 1:332 SANTA FE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5143
Practice Address - Country:US
Practice Address - Phone:760-633-6601
Practice Address - Fax:760-633-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)