Healthcare Provider Details

I. General information

NPI: 1740692714
Provider Name (Legal Business Name): SCRIPPS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD # MS 212A
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

10666 N TORREY PINES RD # MS 212A
LA JOLLA CA
92037-1027
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-7876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA117652
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA117652
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberA117652
License Number StateCA

VIII. Authorized Official

Name: DR. ASHLEY ANN THORSELL
Title or Position: ENDOCRINOLOGY FELLOW
Credential: M.D.
Phone: 858-554-7876