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General NPI Number Information
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NPI Number | 1679103873
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Entity Type | Organization
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Legal Business Name | RADY CHILDREN'S HOSPITAL RESEARCH CENTER
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 7910 FROST ST STE 240
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City | SAN DIEGO
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State | CA
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Zip | 92123-2781
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Country | US
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Telephone | 858-966-8127
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 CHILDRENS WAY # MC5129
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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 |
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Fax |
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Authorized Official
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Title or Position | SVP, EXECUTIVE DIRECTOR
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Name | LYNN PEREZ
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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 | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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