REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP (NPI# 1558463927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558463927 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Other Organization Name | UCSD DEPT OF RADIOLOGY & RADIATION ONCOLOGY |
| Practice Address |
200 West Arbor Drive Mc-8201 Attn: Provider Enrollment Department San Diego CA 92103-8201 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 6195436164 |
| Practice Fax Number | 6195433183 |
| Mailing Telephone | 6195436164 |
| Mailing Fax Number | 6195433183 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MR. MICHAEL DENNIS PRICE (DIRECTOR, REVENUE CYCLE & OPERATION) |
| Authorized Official Telephone | 6195434624 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| US DEPT OF LABOR | 364823305 | 01 | |
| RAILROAD MEDICARE | CQ4024 | 01 | |
| US DEPT OF LABOR | 364823308 | 01 | |
| US DEPT OF LABOR | 364823301 | 01 | |
| CA | GHPP | CGP016905 | 01 |
| CA | 13933 | CMS | 01 |
| CA | CALOPTIMA | GR0012530 | 01 |
| US DEPT OF LABOR | 364823300 | 01 | |
| US DEPT OF LABOR | 364823302 | 01 | |
| CA | RYAN WHITE | 72 | 01 |
| CA | BLUE SHIELD | ZZZ26235Z | 01 |
| US DEPT OF LABOR | 364823303 | 01 | |
| US DEPT OF LABOR | 364823306 | 01 | |
| US DEPT OF LABOR | 364823307 | 01 | |
| US DEPT OF LABOR | 364823304 | 01 | |
| US DEPT OF LABOR | 364823310 | 01 | |
| CA | GR0012530 | 05 |
| Other Name | Type Code |
|---|---|
| UCSD Dept of Radiology & Radiation Oncology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417050956 | Regents of The University of California - Ucsd Medical Group | Radiology | 330 Lewis Street, Ucsd Medical Group - Mc 8201, San Diego, CA 92103-8201 | 2006-09-07 |
| 1306064126 | Regents of The University of California - Ucsd Medical Group | Pharmacy | 200 West Arbor Dr, Mc8201 - Ucsd Provider Enrollment Dept., San Diego, CA 92103-1911 | 2007-04-24 |
| 1336267137 | Regents of The University of California - Ucsd Medical Group | Internal Medicine | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2007-03-27 |
| 1003934803 | Regents of The University of California - Ucsd Medical Group | Internal Medicine | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2007-03-27 |
| 1326141862 | Regents of The University of California - Ucsd Medical Group | Plastic Surgery | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-07 |
| 1376646869 | Regents of The University of California - Ucsd Medical Group | Anesthesiology | 200 West Arbor Dr, Ucsd Mail Code 8986, San Diego, CA 92103-8986 | 2006-09-07 |
| 1356444897 | Regents of The University of California - Ucsd Medical Group | Anesthesiology | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103 | 2006-09-07 |
| 1265535702 | Regents of The University of California - Ucsd Medical Group | Nurse Anesthetist, Certified Registered | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-07 |
| 1386746741 | Regents of The University of California - Ucsd Medical Group | Pediatrics | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-05 |
| 1508968967 | Regents of The University of California - Ucsd Medical Group | Psychiatry & Neurology | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-05 |
| Street Address |
200 WEST ARBOR DRIVE MC-8201 ATTN: PROVIDER ENROLLMENT DEPARTMENT |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-8201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003873175 | Steven Douglas Hickman | Psychologist | 200 West Arbor Drive, Mc8218, San Diego, CA 92103-8218 | 2006-05-01 |
| 1700442449 | Joelle Takahashi | Internal Medicine | 200 West Arbor Drive, San Diego, CA 92103-8770 | 2019-05-17 |
| 1891359154 | Morgan Elizabeth Davis | Student in an Organized Health Care Education/Training Program | 200 West Arbor Drive, San Diego, CA 92103-8829 | 2019-04-23 |
| 1386107548 | Jorge Roberto De La Torre | Student in an Organized Health Care Education/Training Program | 200 West Arbor Drive, Mail Code 8829, San Diego, CA 92103-8829 | 2019-04-12 |
| 1851854806 | Michael Paluy | Student in an Organized Health Care Education/Training Program | 200 West Arbor Drive, Mc 8770, San Diego, CA 92103 | 2019-04-08 |
| 1972062867 | Niels D. Naimon | Student in an Organized Health Care Education/Training Program | 200 West Arbor Drive, Mc8676, San Diego, CA 92103-8676 | 2019-03-19 |
| 1972062735 | Jared Rosen | Student in an Organized Health Care Education/Training Program | 200 West Arbor Drive, San Diego, CA 92103-8425 | 2019-03-19 |
| 1033603543 | Gillian Gadiano | Registered Nurse | 200 West Arbor Drive, San Diego, CA 92103-8501 | 2018-06-18 |
| 1396234662 | Taraz Nicholas Nosrat | Anesthesiology | 200 West Arbor Drive, Mc 8770, San Diego, CA 92103-1911 | 2018-05-02 |
| 1891206736 | Michelle Variz | Registered Nurse | 200 West Arbor Drive, #8501, San Diego, CA 92103-8501 | 2017-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033521190 | Zachary Tyler Berman | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2014-05-23 |
| 1386987261 | Michael Adam Taddonio | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2013-03-29 |
| 1306112057 | Anthony Samir Tadros | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2012-03-27 |
| 1215222757 | Quinn Colin Meisinger | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2011-06-13 |
| 1932414034 | American Access Care of San Diego, LLC | Radiology | 995 Gateway Center Way, Suite 207, San Diego, CA 92102-4500 | 2010-08-12 |
| 1790002400 | Cristian Coroian | Radiology | 4647 Zion Ave, Department of Radiology, San Diego, CA 92120-2507 | 2010-04-21 |
| 1558503359 | Mitchell Thor Gudmundsson | Radiology | 200 W. Arbor Drive, San Diego, CA 92103-8756 | 2009-03-25 |
| 1093963605 | Hamed Aryafar | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9001 | 2008-09-08 |
| 1548416266 | Jeet Minocha | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2008-08-13 |
| 1164682589 | Jonas W Redmond | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2008-06-10 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP.
| 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.