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General NPI Number Information
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NPI Number | 1669864245
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Entity Type | Organization
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Legal Business Name | UCSD HEALTH SYSTEM
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Dates
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Enumeration Date | 02/19/2015
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Last Update Date | 03/03/2015
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Provider Practice Location Address
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Address Line | 410 DICKINSON ST SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92103-6902
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Country | US
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Telephone | 619-471-3877
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Fax | 619-471-9139
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Provider Business Mailing Address
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Address Line | 410 DICKINSON ST SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92103-6902
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Country | US
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Telephone | 619-471-3877
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Fax | 619-471-9139
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Authorized Official
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Title or Position | CHIEF, CLINICAL DIRECTOR
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Name | DR. WILLIAM PERRY
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Credential | PHD
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Telephone | 858-534-2827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18027
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License Number State | CA
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