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General NPI Number Information
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NPI Number | 1780605766
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSD AMBULATORY CARE PHARMACY
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 9350 CAMPUS POINT DR
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City | LA JOLLA
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State | CA
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Zip | 92037-1300
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Country | US
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Telephone | 858-657-8610
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Fax | 858-657-8621
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Provider Business Mailing Address
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Address Line | 200 W ARBOR DR MAIL CODE 8765
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City | SAN DIEGO
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State | CA
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Zip | 92103-9001
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Country | US
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Telephone | 619-543-6194
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Fax | 619-543-5829
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Authorized Official
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Title or Position | DIRECTOR UCSD AMCARE PHARMACY
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Name | MR. GARY HAGNEY
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Credential | RPH
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Telephone | 619-543-6194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHE39292
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PHE39292
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHE39292
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License Number State | CA
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