Provider Demographics
NPI:1528251493
Name:SCRIPPS HEALTH
Entity type:Organization
Organization Name:SCRIPPS HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE EXEC VP/CFO
Authorized Official - Prefix:
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 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:760-633-6805
Mailing Address - Fax:
Practice Address - Street 1:332 SANTA FE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5143
Practice Address - Country:US
Practice Address - Phone:760-633-6805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA760633MR1293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG587Medicare PIN