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General NPI Number Information
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NPI Number | 1093646879
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Entity Type | Organization
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Legal Business Name | PALOMAR UCSD HEALTH AUTHORITY
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Dates
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Enumeration Date | 05/28/2026
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Last Update Date | 05/28/2026
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Provider Practice Location Address
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Address Line | 2185 CITRACADO PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92029-4159
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Country | US
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Telephone | 442-281-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2125 CITRACADO PKWY STE 300
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City | ESCONDIDO
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State | CA
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Zip | 92029-4159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DIANE HANSEN
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Credential |
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Telephone | 760-740-6395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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