UCSD MEDICAL CENTER (NPI# 1952322935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952322935 |
| Entity Type | Organization |
| Organization Name | UCSD MEDICAL CENTER |
| Other Organization Name | UCSD MOORES CANCER CENTER |
| Practice Address |
3855 Health Sciences Dr # 0845 La Jolla CA 92093-0845 |
| Mailing Address |
200 W Arbor Dr Mail Code 8765 San Diego CA 92103-8765 |
| Practice Telephone | 8588226088 |
| Practice Fax Number | 8588226092 |
| Mailing Telephone | 6195436194 |
| Mailing Fax Number | 6195435829 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2017-07-13 |
| Authorized Official Name | GARY HAGNEY (DIRECTOR UCSD AMCARE PHARM) |
| Authorized Official Telephone | 6195436194 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PHE46932 | CA | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHE46932 | CA | Suppliers |
| Y | 333600000X | Pharmacy | PHE46932 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5615488 | 01 | |
| CA | PHB469320 | 05 |
| Other Name | Type Code |
|---|---|
| UCSD MOORES CANCER CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730273582 | Ucsd Medical Center | Home Infusion | 9610 Ridgehaven Ct, Suite A, San Diego, CA 92123-5603 | 2006-10-03 |
| 1013359462 | Ucsd Medical Center | Pharmacy | 9300 Campus Point Dr, Rm Ll-463, La Jolla, CA 92037-7275 | 2013-07-26 |
| 1497014278 | Ucsd Medical Center | General Acute Care Hospital | 200 West Arbor Drive, San Diego, CA 92103 | 2012-05-14 |
| 1306105333 | Ucsd Medical Center | Pharmacy | 9300 Campus Point Dr, La Jolla, CA 92037-1300 | 2012-05-11 |
| 1376641969 | Ucsd Medical Center | Psychiatric Hospital | 200 West Arbor Drive, Mc8937, San Diego, CA 92103-8937 | 2006-09-20 |
| 1598786576 | Ucsd Medical Center | Pharmacy | 200 W Arbor Dr, Rm I317, San Diego, CA 92103-9000 | 2006-07-22 |
| 1316968399 | Ucsd Medical Center | Pharmacy | 4168 Front St, San Diego, CA 92103-2030 | 2006-07-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UCSD MEDICAL CENTER DEPT HLTH SRVCS CONTRACTING | 200 W Arbor Drive Mail Code 8996, San Diego, CA 92103-1911 |
| Street Address |
3855 HEALTH SCIENCES DR # 0845 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92093-0845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356327316 | Hitendra Patel | Internal Medicine | 3855 Health Sciences Dr, La Jolla, CA 92093-2640 | 2005-12-21 |
| 1811512536 | Joseph Anthony Piscitelli | Student in an Organized Health Care Education/Training Program | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2020-06-09 |
| 1356963169 | Daniel Macmanus | Registered Nurse | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2020-05-14 |
| 1043867229 | Melissa Hines-antico | Nurse Practitioner | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2019-08-21 |
| 1851959555 | Robert Kaderka | Student in an Organized Health Care Education/Training Program | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2019-05-29 |
| 1104309442 | Ila Maewal Saunders | Pharmacist | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2018-09-12 |
| 1659854560 | Carie Ann Montesa | Nurse Practitioner | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2018-09-07 |
| 1831699297 | Andrew Menh Sam | Pharmacist | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2018-02-12 |
| 1205344116 | Jennifer Ann Dvorak | Nurse Practitioner | 3855 Health Sciences Dr, La Jolla, CA 92093-1503 | 2018-01-12 |
| 1467903682 | University of California, San Diego | Clinic/Center | 3855 Health Sciences Dr, Suite 1036, La Jolla, CA 92093-0845 | 2016-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902442908 | Forrest N Ridgway | Pharmacist | 3855 Health Sciences Drive #0845, La Jolla, CA 92093 | 2019-11-25 |
| 1578060067 | Michelle Sloan | Student in an Organized Health Care Education/Training Program | 9500 Gilman Dr #0851, La Jolla, CA 92093 | 2018-04-10 |
| 1114372471 | Kevin Ting | Internal Medicine | 9500 Gilman Dr # Mc7411, La Jolla, CA 92093 | 2016-04-24 |
| 1225490147 | Karen Tye | Student in an Organized Health Care Education/Training Program | 3960 Health Sciences Drive, La Jolla, CA 92093 | 2016-03-22 |
| 1457716615 | Christine Pulido | Student in an Organized Health Care Education/Training Program | 9500 Gilman Drive #0851, La Jolla, CA 92093 | 2015-12-15 |
| 1467830489 | Justin Arshed Shaya | Internal Medicine | 3855 Health Sciences Dr #0829, La Jolla, CA 92093 | 2015-05-11 |
| 1225425606 | Brad Hiroshi Kimura | Internal Medicine | 9500 Gilman Dr # Mc9111g, La Jolla, CA 92093 | 2015-04-23 |
| 1407241169 | Courtney Holmes Mckee | Emergency Medicine | 3855 Health Sciences Drive Mc0987, La Jolla, CA 92093 | 2015-03-31 |
| 1528488350 | Arlene Bravo | General Practice | 9500 Gilman Dr # Mc0656, La Jolla, CA 92093 | 2014-04-19 |
| 1710237391 | Chaitanya Pabbati | Psychiatry & Neurology | 9500 Gillman Drive #9116a, La Jolla, CA 92093 | 2012-09-11 |
| Find all providers in zip 92093 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336507565 | Synergy Community Pharmacy LLC | Pharmacy | 7820 Ivanhoe Ave, La Jolla, CA 92037-4501 | 2016-02-02 |
| 1962809780 | Shanzo Inc | Pharmacy | 4150 Regents Park Row, Suite 155, La Jolla, CA 92037-9124 | 2014-11-21 |
| 1306105333 | Ucsd Medical Center | Pharmacy | 9300 Campus Point Dr, La Jolla, CA 92037-1300 | 2012-05-11 |
| 1235241225 | Mashay Inc | Pharmacy | 9850 Genesee Ave, Ste 160, La Jolla, CA 92037-1224 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
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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.