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General NPI Number Information
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NPI Number | 1083999767
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Entity Type | Organization
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Legal Business Name | RADY CHILREN'S HOSPITAL SAN DIEGO
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 5555 GROSSMONT CENTER DR
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City | LA MESA
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State | CA
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Zip | 91942-3019
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Country | US
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Telephone | 619-740-4854
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Fax | 858-966-8558
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Provider Business Mailing Address
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Address Line | 8022 BIRMINGHAM DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-2707
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Country | US
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Telephone | 858-966-5833
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Fax | 858-966-8558
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Authorized Official
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Title or Position | SR. V.P./CFO
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Name | 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 | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | 080000028
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License Number State | CA
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