Provider Demographics
NPI: | 1275899072 |
---|---|
Name: | SCRIPPS HEALTH |
Entity type: | Organization |
Organization Name: | SCRIPPS HEALTH |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE VP/CFO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BRETT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TANDE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 858-678-7227 |
Mailing Address - Street 1: | 10790 RANCHO BERNARDO RD |
Mailing Address - Street 2: | MAIL DROP 4S-205 |
Mailing Address - City: | SAN DIEGO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92127-5705 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 858-554-9100 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10666 N TORREY PINES RD |
Practice Address - Street 2: | |
Practice Address - City: | LA JOLLA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92037-1027 |
Practice Address - Country: | US |
Practice Address - Phone: | 858-554-9100 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-04-05 |
Last Update Date: | 2024-08-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
261QM1300X | ||
CA | 207N00000X, 207P00000X, 207Q00000X, 207R00000X, 207U00000X, 207V00000X, 207W00000X, 207X00000X, 207Y00000X, 207ZP0102X, 208D00000X, 208M00000X, 208VP0000X, 208VP0014X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
No | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | GX918A | Medicare PIN |