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General NPI Number Information
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NPI Number | 1053674564
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Entity Type | Organization
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Legal Business Name | RADY CHILDREN'S HOSPITAL SAN DIEGO
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 3020 CHILDRENS WAY
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City | SAN DIEGO
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State | CA
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Zip | 92123-4223
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Country | US
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Telephone | 858-966-8145
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 CHILDRENS WAY MC 5018
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City | SAN DIEGO
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State | CA
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Zip | 92123-4223
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Country | US
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Telephone | 858-966-1700
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Fax | 858-966-8470
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Authorized Official
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Title or Position | SR VP/CFO
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Name | MR. JAMES ULI
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Credential |
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Telephone | 858-576-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 080000028
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License Number State | CA
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