Regents of the University of Ca-Ucsd Ambulatory Care Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHE37896 Issued in CA

Legal business name

REGENTS OF THE UNIVERSITY OF CA-UCSD AMBULATORY CARE PHARMACY

Doing business as

Ucsd Medical Group Pharmacy

Practice address

330 Lewis St
2ND FLR
San Diego, CA 92103-2108

Phone

(619) 471-9235

Fax

(619) 471-9236

NPI assigned

Jul 22, 2006

Last updated

Jun 10, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSD MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Mr. Gary Hagney, RPH

Title

Director Ucsd Amcare Pharmacy

Phone

(619) 543-6194

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• UCSD MEDICAL GROUP PHARMACY Doing business as

Part of

Regents of the Ucsd

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Regents of the University of California - Ucsd Medical Group

  dba UCSD Dept of Gastroenterology

  • Gastroenterology Physician
  • San Diego, CA
  • NPI 1336267137
  NPPES parent name

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1407877483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "MAIL CODE 8765",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-6194",
            "fax_number": "619-543-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LEWIS ST",
            "address_2": "2ND FLR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032108",
            "telephone_number": "619-471-9235",
            "fax_number": "619-471-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CA-UCSD AMBULATORY CARE PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSD MEDICAL GROUP",
        "enumeration_date": "2006-07-22",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "HAGNEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DIRECTOR UCSD AMCARE PHARMACY",
        "authorized_official_telephone_number": "619-543-6194",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHE37896",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "PHE37896",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHE37896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0546412",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "GU028B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHB378960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSD MEDICAL GROUP PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in San Diego, CA
• Providers in San Diego, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.