NPIMap

Organization Active NPI

Regents of the University of California

Doing business as UCSD Medical Center

  • Specialty Pharmacy
  • San Diego, CA
National Provider Identifier
1417670688
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Doing business as
UCSD Medical Center
Practice address
9610 Ridgehaven CT Ste C
San Diego, CA 92123-5603
Phone
(619) 543-7453
Fax
(619) 268-5019
NPI assigned
Sep 22, 2022
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Tracey Spangenberg
Title
Director, Amcare Pharmacy Services
Phone
(858) 249-4821

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X Primary

Addresses

Primary practice location

9610 Ridgehaven CT Ste C
San Diego, CA 92123-5603

Mailing address

PO Box 743475
Los Angeles, CA 90074-3475

Other identifiers 1

IdentifierTypeStateIssuer
PHE58605OtherCACA STATE PHARMACY LICENSE

Other names 2

  • UCSD Medical Center Doing business as
  • UCSD Specialty Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230331002597 CA DME Supplier - Pharmacy 2769376938 Practice locations: San Diego, CA

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ucsd Medical Center25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
El Centro Regional Medical CenterEl Centro, CA, CCN 050045 Hospital Operational/Managerial Control (100%) Jan 1, 2016
Ucsd Medical CenterSan Diego, CA, CCN 05S025 Hospital Operational/Managerial Control Jan 1, 2016
Accentcare Home Health at UC San Diego Health LLCSan Diego, CA, CCN 053172 Home health agency 5% Or Greater Direct Ownership Interest (30%) Jul 1, 2015
El Centro Outpatient CenterEl Centro, CA, CCN 058518 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2016
Calexico Outpatient CenterCalexico, CA, CCN 058536 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2016

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1417670688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743475",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900743475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 RIDGEHAVEN CT STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921235603",
            "telephone_number": "619-543-7453",
            "fax_number": "619-268-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "SPANGENBERG",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "DIRECTOR, AMCARE PHARMACY SERVICES",
        "authorized_official_telephone_number": "858-249-4821"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE PHARMACY LICENSE",
            "identifier": "PHE58605",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSD Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UCSD Specialty Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.