Organization Active NPI

Urological Associates of San Diego, a Medical Corporation

  • Urology Physician
  • San Diego, CA
National Provider Identifier
1164537775
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGICAL ASSOCIATES OF SAN DIEGO, A MEDICAL CORPORATION
Practice address
3969 4TH Ave
Suite 202
San Diego, CA 92103-3165
Phone
(619) 260-0060
Fax
(619) 260-0460
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
Marianne G. Rochester, M.D.
Title
President
Phone
(619) 260-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

3969 4TH Ave
Suite 202
San Diego, CA 92103-3165

Mailing address

3969 4TH Ave
Suite 202
San Diego, CA 92103-3165
Phone (619) 260-0060

Other identifiers 1

IdentifierTypeStateIssuer
GR0100000MedicaidCA

Other names 1

  • Premier Urology Associates Doing business as

National Provider Directory

National Provider Directory

Locations

752 Medical Center Ct
Ste 302
Chula Vista, CA 91911
Phone (619) 397-4500

5565 Grossmont Center Dr
Ste 358
La Mesa, CA 91942
Phone (619) 465-1816

8875 La Mesa Blvd
Ste 501A
La Mesa, CA 91942

3969 4th Ave
Ste 402
San Diego, CA 92103

3969 4th Ave
San Diego, CA 92103
Phone (619) 291-6191

3969 4th Ave
Ste 202
San Diego, CA 92103
Phone (619) 260-0060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1164537775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "SUITE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-260-0060",
            "fax_number": "619-260-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "SUITE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-260-0060",
            "fax_number": "619-260-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGICAL ASSOCIATES OF SAN DIEGO, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "ROCHESTER",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-260-0060",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Urology 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 Jul 27, 2010; 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.