REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP


Address: 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201
Phone: 6195436164

REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP (NPI# 1881796811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881796811
Entity Type Organization
Organization Name REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP
Other Organization Name UCSD DEPT OF NEUROPHYSIOLOGY
Practice Address 200 West Arbor Drive
Mc-8201 Attn: Provider Enrollment Department
San Diego
CA 92103-8201
Mailing Address Po Box 232410
San Diego
CA 92193-2410
Practice Telephone 6195436164
Practice Fax Number 6195433183
Mailing Telephone 6195436164
Mailing Fax Number 6195433183
Enumeration Date 2006-09-01
Last Update Date 2018-06-21
Authorized Official Name MR. MICHAEL DENNIS PRICE (DIRECTOR, REVENUE CYCLE & OPERATION)
Authorized Official Telephone 6195434624
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2084P0005X Psychiatry & Neurology
Specialization: Neurodevelopmental Disabilities
Allopathic & Osteopathic Physicians
Y 2084N0600X Psychiatry & Neurology
Specialization: Clinical Neurophysiology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA CMS 2327 01
US DEPT OF LABOR 364823305 01
US DEPT OF LABOR 364823306 01
US DEPT OF LABOR 364823301 01
US DEPT OF LABOR 364823300 01
US DEPT OF LABOR 364823303 01
US DEPT OF LABOR 364823308 01
GHPP CGP016905 01
US DEPT OF LABOR 364823307 01
US DEPT OF LABOR 364823310 01
CA BLUE SHIELD ZZZ26233Z 01
US DEPT OF LABOR 364823304 01
CA GR0013561 05
US DEPT OF LABOR 364823302 01
RAILROAD MEDICARE CQ4024 01

Other Provider/Organization Names

Other Name Type Code
UCSD Dept Of Neurophysiology Doing Business As Name - Organization

Other Provider IDs and Locations

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
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

Office Location

Street Address 200 WEST ARBOR DRIVE
MC-8201 ATTN: PROVIDER ENROLLMENT DEPARTMENT
City SAN DIEGO
State CA
Zip Code 92103-8201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003873175 Steven Douglas Hickman Psychologist 200 West Arbor Drive, Mc8218, San Diego, CA 92103-8218 2006-05-01
1700442449 Joelle Takahashi Internal Medicine 200 West Arbor Drive, San Diego, CA 92103-8770 2019-05-17
1891359154 Morgan Elizabeth Davis Student in an Organized Health Care Education/Training Program 200 West Arbor Drive, San Diego, CA 92103-8829 2019-04-23
1386107548 Jorge Roberto De La Torre Student in an Organized Health Care Education/Training Program 200 West Arbor Drive, Mail Code 8829, San Diego, CA 92103-8829 2019-04-12
1851854806 Michael Paluy Student in an Organized Health Care Education/Training Program 200 West Arbor Drive, Mc 8770, San Diego, CA 92103 2019-04-08
1972062867 Niels D. Naimon Student in an Organized Health Care Education/Training Program 200 West Arbor Drive, Mc8676, San Diego, CA 92103-8676 2019-03-19
1972062735 Jared Rosen Student in an Organized Health Care Education/Training Program 200 West Arbor Drive, San Diego, CA 92103-8425 2019-03-19
1033603543 Gillian Gadiano Registered Nurse 200 West Arbor Drive, San Diego, CA 92103-8501 2018-06-18
1396234662 Taraz Nicholas Nosrat Anesthesiology 200 West Arbor Drive, Mc 8770, San Diego, CA 92103-1911 2018-05-02
1891206736 Michelle Variz Registered Nurse 200 West Arbor Drive, #8501, San Diego, CA 92103-8501 2017-10-18
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2084N0600X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Clinical Neurophysiology

Taxonomy Definition

Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316560378 Green Flash Physician Oversight PC Psychiatry & Neurology 2868 Bayside Walk Unit C, San Diego, CA 92109-8119 2020-05-26
1508932849 Gayle Ellen Hicks Psychiatry & Neurology 2815 Camino Del Rio South, Suite 220, San Diego, CA 92108 2006-11-28
1942386859 Alissa Ann Carnelian Psychiatry & Neurology 4227 Maryland St Apt 7, San Diego, CA 92103-2346 2006-10-31
1548603186 Dominic Alexander Ferrey I Psychiatry & Neurology 200 W Arbor Dr, San Diego, CA 92103 2013-04-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1659994739 Jey Neuro Center, Inc Psychiatry & Neurology 2005 Eye Street #8-501, Bakersfield, CA 93301-4451 2020-05-22
1578116877 La Neuro Medical Group Psychiatry & Neurology 11843 Dorothy St Apt 2, Los Angeles, CA 90049-4456 2019-07-17
1518527613 Neuroguard Pro Psychiatry & Neurology 2932 N Cottonwood St Unit 16, Orange, CA 92865-1235 2019-06-19
1750857801 Tms Depression Center of San Diego Psychiatry & Neurology 613 W Valley Pkwy Ste 102, Escondido, CA 92025-2550 2018-10-16
1225530637 Iom Neuro Pro Reader Psychiatry & Neurology 9300 Santa Anita Ave, Suite 101, Rancho Cucamonga, CA 91730 2018-03-01
1437579851 Sami Bajwa Psychiatry & Neurology 7240 N Van Ness Blvd, Fresno, CA 93711-0470 2014-04-24
1780935130 Dawn Eliashiv Md Inc. A Professional Medical Corporation Psychiatry & Neurology 8635 W 3rd St Ste 1080w, Los Angeles, CA 90048-6183 2012-09-25
1073821922 Yuvraj Singh Grewal Psychiatry & Neurology 23861 Mcbean Pkwy Ste A4, Santa Clarita, CA 91355-2003 2010-09-14
1952629263 Roger Bertoldi Md Professional Corporation Psychiatry & Neurology 8610 S. Sepulveda Blvd., Los Angeles, CA 90045 2010-05-11
1063686202 Mark E Vonzastrow Psychiatry & Neurology 600 16th St, N212e Genentech Hall / Ucsf, San Francisco, CA 94158-2517 2008-04-18
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Competitor

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City SAN DIEGO
Zip Code 92103

Improve Information

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Dataset Information

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.

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