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General NPI Number Information
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NPI Number | 1518235720
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Entity Type | Organization
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Legal Business Name | RADY CHILDREN HOSPITAL AND HEALTH CENTER
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 3020 CHILDRENS WAY 5081
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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 | 858-966-5425
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Provider Business Mailing Address
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Address Line | 3020 CHILDRENS WAY 5081
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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 | 858-966-5425
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. ROGER G ROUX
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Credential |
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Telephone | 85896617005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 15277
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License Number State | CA
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