RADY CHILDREN'S HOSPITAL - SAN DIEGO NPI 1710065933

NPI Information

NPI: 1710065933
Provider Name: RADY CHILDREN'S HOSPITAL - SAN DIEGO

Former Legal Business Name: CHILDREN'S HOSPITAL - SAN DIEGO

Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
3020 CHILDRENS WAY
MAIL CODE 5002
SAN DIEGO, CA
ZIP 92123
Phone: (858) 966-1700
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RADY CHILDREN'S HOSPITAL - SAN DIEGO is a developmental disabilities clinic center in San Diego, CA. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). RADY CHILDREN'S HOSPITAL - SAN DIEGO NPI is 1710065933. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Children's Hospital - San Diego.

The provider's business location address is:

3020 CHILDRENS WAY
MAIL CODE 5002
SAN DIEGO, CA
ZIP 92123-223
Phone: (858) 966-1700

The provider's authorized official is James Joseph Uli .
The authorized official title is Sr. Vp/cfo and has the following contact phone number (858) 966-5824.

The CLIA number assigned to this NPI record is 05D2152737 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 7/13/2020.

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	261Q00000X	Clinic/Center				No
2	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	080000028	CALIFORNIA	No
3	261QH0700X	Clinic/Center	Hearing and Speech			No
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
5	261QP2000X	Clinic/Center	Physical Therapy			No
6	261QR0400X	Clinic/Center	Rehabilitation			No
7	282NC2000X	General Acute Care Hospital	Children	080000028	CALIFORNIA	No
8	405300000X	Prevention Professional				No
9	261QD1600X	Clinic/Center	Developmental Disabilities			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	CGP000355	MEDICAID	CALIFORNIA
2	CGP165365	MEDICAID	CALIFORNIA
3	HSC30271F	MEDICAID	CALIFORNIA
4	053303	OTHER	CALIFORNIA	BLUE CROSS OF CALIFORNIA
5	53125301	MEDICAID	HAWAII
6	ZZT40271F	MEDICAID	CALIFORNIA
7	053303	OTHER	CALIFORNIA	PINNACLE CLAIMS MANAGEMENT
8	ZZT30271F	MEDICAID	CALIFORNIA
9	053303	OTHER	CALIFORNIA	GIC INDEMNITY PLAN
10	053303	OTHER	CALIFORNIA	WESTERN GROWERS
11	ZZZH3702Z	OTHER	CALIFORNIA	BLUE SHIELD OF CA

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

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