REGENTS OF THE UNIVESITY OF CALIFORNIA - UCSD MEDICAL GROUP (NPI# 1235232778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235232778 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVESITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Other Organization Name | UCSD DEPT OF CARDIOTHORACIC SURGERY |
| Practice Address |
200 West Arbor Dr Mc8201-ucsd Medical Group, Provider Enrollment Dept. San Diego CA 92103-1911 |
| Practice Telephone | 6195433183 |
| Practice Fax Number | 6195433183 |
| Mailing Telephone | 6195431884 |
| Mailing Fax Number | 6195433183 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MR. JOHN DUNCAN CAMPBELL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6195437727 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| US DEPT OF LABOR | 364823307 | 01 | |
| US DEPT OF LABOR | 364823310 | 01 | |
| CA | GHPP | CGP016905 | 01 |
| CA | CALOPTIMA | ZZZP3720Z | 01 |
| US DEPT OF LABOR | 364823302 | 01 | |
| CA | BLUE SHIELD | ZZZP3720Z | 01 |
| US DEPT OF LABOR | 364823300 | 01 | |
| US DEPT OF LABOR | 364823306 | 01 | |
| CA | CMS | 2327 | 01 |
| US DEPT OF LABOR | 364823305 | 01 | |
| US DEPT OF LABOR | 364823303 | 01 | |
| US DEPT OF LABOR | 364823308 | 01 | |
| RAILROAD MEDICARE | CQ4024 | 01 | |
| US DEPT OF LABOR | 364823301 | 01 | |
| US DEPT OF LABOR | 364823304 | 01 | |
| CA | ZZZP3720Z | 05 |
| Other Name | Type Code |
|---|---|
| UCSD DEPT OF CARDIOTHORACIC SURGERY | Other Name - Individual/Organization |
| Street Address |
200 WEST ARBOR DR MC8201-UCSD MEDICAL GROUP, PROVIDER ENROLLMENT DEPT. |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548222532 | Brandie Jo Ciceri | Nurse Practitioner | 200 West Arbor Dr, Uscd Medical Center - Dept. of Gi, San Diego, CA 92103 | 2006-04-05 |
| 1649799370 | Dmitri Lerner | Pharmacist | 200 West Arbor Dr, San Diego, CA 92103-7695 | 2017-09-13 |
| 1568726602 | Vincent Cheung | Student in an Organized Health Care Education/Training Program | 200 West Arbor Dr, Division of Neurosurgery, Mailcode 8893, San Diego, CA 92103 | 2012-07-03 |
| 1629385836 | Gert Diederick Victor Pretorius | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 West Arbor Dr, Mc 8892, San Diego, CA 92103-9001 | 2010-09-09 |
| 1275702797 | Frank J Papatheofanis | Nuclear Medicine | 200 West Arbor Dr, Ucsd Radop;pgu Mc 8758, San Diego, CA 92103-8758 | 2008-02-28 |
| 1700087376 | Michael R Peterson | Pathology | 200 West Arbor Dr, Mc 8720, San Diego, CA 92103-8720 | 2007-05-30 |
| 1275744252 | Merry Christine Blantz | Nurse Practitioner | 200 West Arbor Dr, San Diego, CA 92103-8409 | 2007-05-24 |
| 1699988667 | Julie Lynn Marek Bykowski | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1356554323 | Sharon Brouha | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1770796781 | Danielle B Nanigian | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
| 1972913424 | Cleland C. Landolt, M.d., Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7790 Via Francesco, Unit 5, San Diego, CA 92129-5153 | 2014-05-06 |
| 1528183928 | Craig R Larson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 8010 Frost St Ste 408, San Diego, CA 92123-4222 | 2007-03-21 |
| 1649203415 | Stuart W Jamieson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 West Arbor Drive Mc 8892, Ucsd Medical Center, San Diego, CA 92103 | 2006-07-07 |
| 1164495750 | Daniel Lawrence Gramins | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Veterans Administration Medical Ctr, 3350 La Jolla Village Drive (112j), San Diego, CA 92161-8892 | 2006-02-13 |
| 1902888522 | Joseph H Chammas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 8010 Frost St, Suite 408, San Diego, CA 92123-2778 | 2005-11-18 |
| 1790766038 | Adamson and Dembitsky Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 8010 Frost St., Ste. 408, San Diego, CA 92123 | 2005-11-11 |
| 1265071005 | Srujan Ganta | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3020 Childrens Way, San Diego, CA 92123-4223 | 2019-12-26 |
| 1033683719 | Mark Joseph Kearns | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2019-01-16 |
| 1912385345 | Apex Perfusion Services, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10531 4s Commons Dr, Suite 489, San Diego, CA 92127-3517 | 2015-05-18 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on REGENTS OF THE UNIVESITY OF CALIFORNIA - UCSD MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.