REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP (NPI# 1740382993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740382993 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Other Organization Name | UCSD DEPT OF SURGERY |
| Practice Address |
200 West Arbor Dr Mc8201-ucsd Medical Group, Provider Enrollment Dept. San Diego CA 92103-1911 |
| Practice Telephone | 6195431884 |
| Practice Fax Number | 6195433183 |
| Mailing Telephone | 6195431884 |
| Mailing Fax Number | 6195433183 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MR. JOHN DUNCAN CAMPBELL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6195437727 |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA - UCSD MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208C00000X | Colon & Rectal Surgery | Allopathic & Osteopathic Physicians | ||
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CMS | 2327 | 01 |
| US DEPT OF LABOR | 364823310 | 01 | |
| US DEPT OF LABOR | 364823305 | 01 | |
| US DEPT OF LABOR | 364823300 | 01 | |
| US DEPT OF LABOR | 364823302 | 01 | |
| US DEPT OF LABOR | 364823303 | 01 | |
| CA | RAILROAD MEDICARE | CQ4024 | 01 |
| CA | BLUE SHIELD | ZZZ26270Z | 01 |
| US DEPT OF LABOR | 364823301 | 01 | |
| US DEPT OF LABOR | 364823307 | 01 | |
| CA | GRE000080 | 05 | |
| CA | CALOPTIMA | ZZZP3710Z | 01 |
| US DEPT OF LABOR | 364823306 | 01 | |
| US DEPT OF LABOR | 364823308 | 01 | |
| CA | ZZZP3710Z | 05 | |
| US DEPT OF LABOR | 364823304 | 01 | |
| CA | GHPP | CGP016905 | 01 |
| Other Name | Type Code |
|---|---|
| UCSD DEPT OF SURGERY | Other Name - Individual/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 DR MC8201-UCSD MEDICAL GROUP, PROVIDER ENROLLMENT DEPT. |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548222532 | Brandie Jo Ciceri | Nurse Practitioner | 200 West Arbor Dr, Uscd Medical Center - Dept. of Gi, San Diego, CA 92103 | 2006-04-05 |
| 1649799370 | Dmitri Lerner | Pharmacist | 200 West Arbor Dr, San Diego, CA 92103-7695 | 2017-09-13 |
| 1568726602 | Vincent Cheung | Student in an Organized Health Care Education/Training Program | 200 West Arbor Dr, Division of Neurosurgery, Mailcode 8893, San Diego, CA 92103 | 2012-07-03 |
| 1629385836 | Gert Diederick Victor Pretorius | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 West Arbor Dr, Mc 8892, San Diego, CA 92103-9001 | 2010-09-09 |
| 1275702797 | Frank J Papatheofanis | Nuclear Medicine | 200 West Arbor Dr, Ucsd Radop;pgu Mc 8758, San Diego, CA 92103-8758 | 2008-02-28 |
| 1700087376 | Michael R Peterson | Pathology | 200 West Arbor Dr, Mc 8720, San Diego, CA 92103-8720 | 2007-05-30 |
| 1275744252 | Merry Christine Blantz | Nurse Practitioner | 200 West Arbor Dr, San Diego, CA 92103-8409 | 2007-05-24 |
| 1699988667 | Julie Lynn Marek Bykowski | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1356554323 | Sharon Brouha | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 1770796781 | Danielle B Nanigian | Radiology | 200 West Arbor Dr, Mc 8756, San Diego, CA 92103-8756 | 2007-05-07 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295361772 | William Robert Berry | Surgery | 5775 Del Cerro Blvd, San Diego, CA 92120-4513 | 2020-03-17 |
| 1376185116 | Charles Theuer | Surgery | 4350 La Jolla Village Dr Ste 800, San Diego, CA 92122-1247 | 2019-10-14 |
| 1538656202 | Stewart Reese Logan | Surgery | 200 W Arbor Dr # Mc7220, San Diego, CA 92103-1911 | 2018-04-18 |
| 1447773114 | R R Gohil Md Apc | Surgery | 6386 Alvarado Ct Ste 330, San Diego, CA 92120-4908 | 2017-07-25 |
| 1720475148 | Advanced Wound Care, Inc | Surgery | 5124 Bloch St, San Diego, CA 92122-4005 | 2015-04-23 |
| 1841532843 | San Diego Emergency Physician Services, Inc. | Surgery | 6487 Dwane Ave, San Diego, CA 92120-3924 | 2013-03-18 |
| 1336488485 | Victor Herbert Lidner | Surgery | 809 Deal Ct, San Diego, CA 92109-8131 | 2013-02-10 |
| 1588909097 | San Diego Advanced Surgery P.C. | Surgery | 3245 University Ave # 501, San Diego, CA 92104-2009 | 2012-12-10 |
| 1700121472 | Vadim Avulov | Surgery | 6699 Alvarado Rd Ste 2309, San Diego, CA 92120-5241 | 2012-12-06 |
| 1194075861 | Rachel Kaye Voss | Surgery | 3146 Cowley Way, Apt 4, San Diego, CA 92117-6519 | 2012-09-10 |
| 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.