NPIMap

Organization Active NPI

San Diego State University Student Health Services

  • Clinic/Center
  • San Diego, CA
National Provider Identifier
1083715890
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAN DIEGO STATE UNIVERSITY STUDENT HEALTH SERVICES
Practice address
5500 Campanile Dr
San Diego, CA 92182-4701
Phone
(619) 594-4325
Fax
(619) 594-4260
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
David Burns
Title
Associate Vice President
Phone
(619) 594-6018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5500 Campanile Dr
San Diego, CA 92182-4701

Mailing address

5500 Campanile Dr
San Diego, CA 92182-4701
Phone (619) 594-4325

Other identifiers 1

IdentifierTypeStateIssuer
EXE70109FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
San Diego State University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1083715890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 CAMPANILE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921824701",
            "telephone_number": "619-594-4325",
            "fax_number": "619-594-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CAMPANILE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921824701",
            "telephone_number": "619-594-4325",
            "fax_number": "619-594-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO STATE UNIVERSITY STUDENT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ASSOCIATE VICE PRESIDENT",
        "authorized_official_telephone_number": "619-594-6018"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EXE70109F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.