Healthcare Provider Details

I. General information

NPI: 1043665425
Provider Name (Legal Business Name): SCRIPPS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 4TH AVE. SUITE 110
SAN DIEGO CA
92103-2116
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD. 2ND FL.
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 858-678-7111
  • Fax: 858-678-6663
Mailing address:
  • Phone: 858-678-7111
  • Fax: 858-678-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY54317
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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