NPIMap

Organization Active NPI

Regents of the University of California

Doing business as UCSD Pediatric and Adolescent Associates

  • Pediatric Adolescent Medicine Physician
  • San Diego, CA
National Provider Identifier
1013035716
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Doing business as
UCSD Pediatric and Adolescent Associates
Practice address
7910 Frost Street
Ste 350
San Diego, CA 92123-2771
Phone
(858) 496-4800
Fax
(858) 496-4850
NPI assigned
Mar 27, 2007
Last updated
Sep 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bretten Drake Pickering, M.D.NPI 1841223344
Title
Division Chief of General Academic
Phone
(858) 496-4827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

7910 Frost Street
Ste 350
San Diego, CA 92123-2771

Mailing address

3860 Calle Fortunada
Ste 200
San Diego, CA 92123-4800
Phone (858) 502-1135

Other identifiers 2

IdentifierTypeStateIssuer
GR0105540MedicaidCA
ZZZ69468ZOtherCABLUE SHIELD

Other names 1

  • UCSD Pediatric and Adolescent Associates Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1065788Ucsd Pediatric Associates7910 Frost St Ste 350, San Diego, CA 92123Certificate of waiverJan 23, 2028

National Provider Directory

National Provider Directory

Locations

8910 Villa La Jolla Dr
La Jolla, CA 92037
Phone (858) 249-6800

8910 Villa La Jolla Dr
Ste 110
La Jolla, CA 92037
Phone (858) 203-4962

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1013035716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234800",
            "telephone_number": "858-502-1135",
            "fax_number": "858-636-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST STREET",
            "address_2": "STE 350",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232771",
            "telephone_number": "858-496-4800",
            "fax_number": "858-496-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "PICKERING",
        "authorized_official_first_name": "BRETTEN",
        "authorized_official_middle_name": "DRAKE",
        "authorized_official_title_or_position": "DIVISION CHIEF OF GENERAL ACADEMIC",
        "authorized_official_telephone_number": "858-496-4827",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0105540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ69468Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSD Pediatric and Adolescent Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.