| The Regents Of The University Of California | |
|
200 West Arbor Drive Mc8937 San Diego CA 92103-8937 | |
| (619) 543-6308 | |
| (619) 543-3004 |
| Full Name | The Regents Of The University Of California |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 200 West Arbor Drive, San Diego, California |
| Authorized Official Name and Position | Lori Donaldson (CFO) |
| Authorized Official Contact | 6195436060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Regents Of The University Of California File 556631 Los Angeles CA 90074-0001 Ph: (619) 543-6308 | The Regents Of The University Of California 200 West Arbor Drive Mc8937 San Diego CA 92103-8937 Ph: (619) 543-6308 |
| NPI Number | 1376641969 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 2769376938 |
|---|---|
| Medicare Enrollment ID | O20120402000655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376641969 | NPI | - | NPPES |
| HSM30025F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 090000101 (California) | Primary |
| 283Q00000X | Psychiatric Hospital | 090000101 (California) | Secondary |
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