Healthcare Provider Details

I. General information

NPI: 1083492615
Provider Name (Legal Business Name): SAN DIEGO REGIONAL HEALTH INFORMATION EXCHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 CALLE FORTUNADA STE 101
SAN DIEGO CA
92123-4802
US

IV. Provider business mailing address

3860 CALLE FORTUNADA STE 101
SAN DIEGO CA
92123-4802
US

V. Phone/Fax

Practice location:
  • Phone: 858-379-6690
  • Fax:
Mailing address:
  • Phone: 858-379-6690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. NIC HESS
Title or Position: CHIEF TECHNOLOGY OFFICER
Credential:
Phone: 858-736-4543