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General NPI Number Information
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NPI Number | 1710065933
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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 | 11/02/2006
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3020 CHILDRENS WAY # 5002
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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 | 858-576-1700
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Fax | 858-966-4051
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Provider Business Mailing Address
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Address Line | 3020 CHILDRENS WAY MAIL CODE 5002
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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 |
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Authorized Official
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Title or Position | SR. DIRECTOR, REVENUE CYCLE APPLIC
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Name | MR. MICHAEL HESTER
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Credential |
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Telephone | 858-966-6779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 080000028
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 080000028
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License Number State | CA
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