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General NPI Number Information
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NPI Number | 1033666706
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Entity Type | Organization
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Legal Business Name | SCRIPPS CLINIC MEDICAL GROUP
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 10666 N TORREY PINES RD 201 N
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City | LA JOLLA
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State | CA
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Zip | 92037-1027
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Country | US
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Telephone | 858-554-6158
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Fax |
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Provider Business Mailing Address
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Address Line | 10666 N TORREY PINES RD 201 N
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City | LA JOLLA
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State | CA
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Zip | 92037-1027
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Country | US
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Telephone | 858-554-6158
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Fax |
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Authorized Official
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Title or Position | SENIOR VP
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Name | JIM MULVEY
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Credential |
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Telephone | 858-554-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A85730
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License Number State | CA
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