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General NPI Number Information
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NPI Number | 1659589604
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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 | 05/21/2007
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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 | 619-420-5611
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Fax |
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Provider Business Mailing Address
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Address Line | 222 MONTGOMERY ST
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City | CHULA VISTA
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State | CA
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Zip | 91911-5839
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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 | CHILD &FAMILY SPECIALIST
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Name | GLORIA ONTIVEROS
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Credential |
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Telephone | 619-420-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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