Healthcare Provider Details

I. General information

NPI: 1992782841
Provider Name (Legal Business Name): SCRIPPS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9888 GENESEE AVE
LA JOLLA CA
92037-1276
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD # 4S-303
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 858-457-4123
  • Fax:
Mailing address:
  • Phone: 858-657-4218
  • Fax: 858-657-4243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number080000050
License Number StateCA

VIII. Authorized Official

Name: RICHARD ROTHBERGER
Title or Position: EVP CFO
Credential:
Phone: 858-678-6828