REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP (NPI# 1417050956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417050956 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Other Organization Name | UCSD RADIOLOGY MED GROUP |
| Practice Address |
330 Lewis Street Ucsd Medical Group - Mc 8201 San Diego CA 92103-8201 |
| Mailing Address |
200 West Arbor Dr Ucsd Medical Group Mc-8201 San Diego CA 92103-8201 |
| Practice Telephone | 6195431899 |
| Practice Fax Number | 6195433183 |
| Mailing Telephone | 6195431899 |
| Mailing Fax Number | 6195433183 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | DR. THOMAS V MCAFEE (PHYSICIAN IN CHIEF) |
| Authorized Official Telephone | 6195435338 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CMS | 13933 | 01 |
| CA | RYAN WHITE | 72 | 01 |
| CA | BLUE SHIELD GRP # | ZZZ26235Z | 01 |
| CA | RAILROAD MEDICARE | CQ4024 | 01 |
| CA | GHPP | CGP016905 | 01 |
| CA | GR0013571 | 05 | |
| CA | CALOPTIMA | GR0013571 | 01 |
| Other Name | Type Code |
|---|---|
| UCSD RADIOLOGY MED GROUP | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306064126 | Regents of The University of California - Ucsd Medical Group | Pharmacy | 200 West Arbor Dr, Mc8201 - Ucsd Provider Enrollment Dept., San Diego, CA 92103-1911 | 2007-04-24 |
| 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 |
330 LEWIS STREET UCSD MEDICAL GROUP - MC 8201 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-8201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932257268 | Ottar Viker Lunde | Internal Medicine | 330 Lewis Street, Mail Code 8201-a, San Diego, CA 92103-8201 | 2007-01-05 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790208155 | St. Jude Radiology Medical Group, Inc. | Radiology | 8070 Entrada De Luz E, San Diego, CA 92127-2561 | 2017-07-18 |
| 1225586423 | Regional Diagnostic Imaging | Radiology | 3731 Torrey View Ct, San Diego, CA 92130-2623 | 2016-09-15 |
| 1093127680 | William James Tom | Radiology | 200 West Arbor Drive, Mc 0834, San Diego, CA 92103-0834 | 2014-05-30 |
| 1649697947 | Ashley Caitlin Altman | Radiology | Uc San Diego Health, 200 West Arbor Drive, Mc 8829, San Diego, CA 92103 | 2014-03-25 |
| 1477811693 | Michele Christina Mcgahan | Radiology | 8745 Aero Drive #200, San Diego, CA 92193-3540 | 2012-04-25 |
| 1447557996 | Luke R Scalcione | Radiology | 7540 Charmant Dr, Apt 1216, San Diego, CA 92122-5044 | 2011-02-18 |
| 1144537606 | Jasmine Jamin Koo | Radiology | 5330 Carroll Canyon Rd Ste 140, San Diego, CA 92121-3758 | 2010-09-04 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1881837748 | John Joseph Krol | Radiology | 11125 Red Cedar Dr, San Diego, CA 92131-1309 | 2009-04-08 |
| 1700022712 | Thomas N. Folan | Radiology | 425 W Beech St Unit 1707, San Diego, CA 92101-2965 | 2008-12-22 |
| 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.