RADY CHILDREN'S HEALTH SERVICES-SAN DIEGO NPI 1649369653

NPI Information

NPI: 1649369653
Provider Name: RADY CHILDREN'S HEALTH SERVICES-SAN DIEGO

Doing Business As: SAN DIEGO CHILDREN'S HEALTH SERVICES

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
3020 CHILDRENS WAY
MAILCODE 5127
SAN DIEGO, CA
ZIP 92123
Phone: (858) 576-1700
Get Directions

RADY CHILDREN'S HEALTH SERVICES-SAN DIEGO is a dental clinic center in San Diego, CA. RADY CHILDREN'S HEALTH SERVICES-SAN DIEGO NPI is 1649369653. The provider is registered as an organization entity type.
The provider Is Doing Business As San Diego Children's Health Services.

The provider's business location address is:

3020 CHILDRENS WAY
MAILCODE 5127
SAN DIEGO, CA
ZIP 92123-223
Phone: (858) 576-1700
Fax: (858) 966-8097

The provider's authorized official is Tiffany Lynn Kavanaugh .
The authorized official title is Office Manager and has the following contact phone number (858) 966-5802.

The CLIA number assigned to this NPI record is 05D1018168 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental		CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G93636-01	MEDICAID	CALIFORNIA
2	G98449-01	OTHER	CALIFORNIA	HEALTHY FAMILY STATE PROG

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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