1700829199 NPI number — SCRIPPS HEALTH

Table of content: (NPI 1700829199)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700829199 NPI number — SCRIPPS HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCRIPPS HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SCRIPPS MEMORIAL HOSPITAL ENCINITAS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700829199
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10790 RANCHO BERNARDO RD # 4S-303
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92127-5705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-927-5328
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
354 SANTA FE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENCINITAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92024-5142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-457-4123
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TANDE
Authorized Official First Name:
BRETT
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP/CFO
Authorized Official Telephone Number:
858-678-7227

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  08 0000148 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 163SHEN . This is a "COUNTY MED SRVC SD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZT 30503G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26 . This is a "KAISER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: SMEN . This is a "UNIVERSAL CARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 6150660 . This is a "AETNA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: HSC 30503G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZT 40503G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZZD0503Z . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 050503B000000 . This is a "TRAILBLAZERS 1011" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 050503 . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: HSC30503G . This is a "MCL HMO IN-PATIENT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZT 40503G . This is a "MCL HMO OUT-PATIENT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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