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General NPI Number Information
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NPI Number | 1780756411
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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 | 11/15/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 3453 AVELEY PL
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City | SAN DIEGO
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State | CA
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Zip | 92111-4727
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Country | US
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Telephone | 858-541-2646
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Fax | 858-966-8558
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Provider Business Mailing Address
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Address Line | 8022 BIRMINGHAM DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-2707
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Country | US
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Telephone | 858-966-5833
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Fax | 858-966-8558
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JAMES ULI
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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 | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 090000644
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License Number State | CA
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