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NPI Code Detail

MEDICARE: SCRIPPS CLINIC MEDICAL LABORATORIES

MEDICARE: SCRIPPS CLINIC MEDICAL LABORATORIES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical LaboratoryCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578549044
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCRIPPS CLINIC MEDICAL LABORATORIES
Provider Business Mailing Address
First Line : 10790 RANCHO BERNARDO RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92127-5705
Country : US
Telephone Number : 858-487-1800
Fax Number :
Provider Business Practice Location Address
First Line : 15004 INNOVATION DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-3491
Country : US
Telephone Number : 858-487-1800
Fax Number :
Authorized Official
Title or Position : LABORATORY DIRECTOR
Name : DR. BETH PALLA
Credential : M.D.
Telephone Number : 858-554-8605
Provider Enumeration Date : 12/16/2005
Last Update Date : 03/16/2022

Similar Medicare Providers

1902130842 — MRS. TIARA CHRISTINE ESANI P.A.
Practice Location Address:
15004 INNOVATION DR
SAN DIEGO, CA
92128-3491
Practice Phone: 858-554-7272
Practice Fax:
1851376222 — SCRIPPS CLINIC MEDICAL GROUP
Practice Location Address:
15004 INNOVATION DR
SAN DIEGO, CA
92128-3491
Practice Phone: 858-487-1800
Practice Fax:
1487628046 — MRS. CAMBRIA MARCY DEMARCO PERRY RN, NP
Practice Location Address:
15004 INNOVATION DR
SAN DIEGO, CA
92128-3491
Practice Phone: 858-487-1800
Practice Fax:
1164487575 — JANINE HONATH OTRL, CHT
Practice Location Address:
15004 INNOVATION DR , STE 120
SAN DIEGO, CA
92128-3491
Practice Phone: 858-605-7313
Practice Fax:
1770540379 — DR. KENNETH A. SCHILD M.D.
Practice Location Address:
15004 INNOVATION DR
SAN DIEGO, CA
92128-3491
Practice Phone: 858-605-7171
Practice Fax:
1902864358 — DR. MARK DAVID SHALAUTA M.D.
Practice Location Address:
15004 INNOVATION DR
SAN DIEGO, CA
92128-3491
Practice Phone: 858-487-1800
Practice Fax: 858-605-7106

Directions to “SCRIPPS CLINIC MEDICAL LABORATORIES ” Practice Location

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