REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP (NPI# 1306064126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306064126 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Other Organization Name | UCSD MEDICAL GROUP |
| Practice Address |
200 West Arbor Dr Mc8201 - Ucsd Provider Enrollment Dept. San Diego CA 92103-1911 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 8009268273 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | MR. THOMAS MOORE (CEO UCSD CLINICAL FACULTY PRACTICE) |
| Authorized Official Telephone | 6195438300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| UCSD Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417050956 | Regents of The University of California - Ucsd Medical Group | Radiology | 330 Lewis Street, Ucsd Medical Group - Mc 8201, San Diego, CA 92103-8201 | 2006-09-07 |
| 1336267137 | Regents of The University of California - Ucsd Medical Group | Internal Medicine | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2007-03-27 |
| 1003934803 | Regents of The University of California - Ucsd Medical Group | Internal Medicine | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2007-03-27 |
| 1326141862 | Regents of The University of California - Ucsd Medical Group | Plastic Surgery | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-07 |
| 1376646869 | Regents of The University of California - Ucsd Medical Group | Anesthesiology | 200 West Arbor Dr, Ucsd Mail Code 8986, San Diego, CA 92103-8986 | 2006-09-07 |
| 1356444897 | Regents of The University of California - Ucsd Medical Group | Anesthesiology | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103 | 2006-09-07 |
| 1265535702 | Regents of The University of California - Ucsd Medical Group | Nurse Anesthetist, Certified Registered | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-07 |
| 1386746741 | Regents of The University of California - Ucsd Medical Group | Pediatrics | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-05 |
| 1508968967 | Regents of The University of California - Ucsd Medical Group | Psychiatry & Neurology | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-05 |
| 1558463927 | Regents of The University of California - Ucsd Medical Group | Radiology | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-05 |
| Street Address |
200 WEST ARBOR DR MC8201 - UCSD 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 | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376168591 | Ogo-sma Services LLC | Durable Medical Equipment & Medical Supplies | 8901 Activity Rd Ste 223, San Diego, CA 92126-4432 | 2020-06-12 |
| 1952921850 | Proline Med Supply LLC | Durable Medical Equipment & Medical Supplies | 2667 Camino Del Rio S Ste 101, San Diego, CA 92108-3763 | 2020-04-21 |
| 1598385866 | Modern Therapies LLC | Durable Medical Equipment & Medical Supplies | 2870 4th Ave Apt 401, San Diego, CA 92103-6273 | 2020-04-16 |
| 1639707060 | Derma Hair Group | Durable Medical Equipment & Medical Supplies | 5703 Oberlin Dr Ste 302, San Diego, CA 92121-1743 | 2020-03-31 |
| 1205464658 | Proactive Care Pharmacy, LLC. | Durable Medical Equipment & Medical Supplies | 7345 Linda Vista Rd Ste E, San Diego, CA 92111-5800 | 2020-03-31 |
| 1619502788 | Inova Labs Inc. | Durable Medical Equipment & Medical Supplies | 7581 Convoy Ct, San Diego, CA 92111-1113 | 2020-03-09 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1972147825 | Binyam Gebregziaber Gebrehiwot I | Durable Medical Equipment & Medical Supplies | 4951 68th St, San Diego, CA 92115-1704 | 2019-11-04 |
| 1801438841 | Goodchoice Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 4760 Mission Gorge Pl Ste D, San Diego, CA 92120-4230 | 2019-10-10 |
| 1366090029 | Shur-in, Inc. | Durable Medical Equipment & Medical Supplies | 7452 Rowena Street, San Diego, CA 92119-1241 | 2019-08-27 |
| Find all providers in SAN DIEGO | ||||
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| 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.