Provider Demographics
NPI:1962531244
Name:UCSD OCCUPATIONAL MEDICINE
Entity type:Organization
Organization Name:UCSD OCCUPATIONAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-543-7071
Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:MC8800
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9001
Mailing Address - Country:US
Mailing Address - Phone:619-471-9210
Mailing Address - Fax:
Practice Address - Street 1:330 LEWIS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2108
Practice Address - Country:US
Practice Address - Phone:619-471-9210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine