NPIMap

Organization Active NPI

UC San Diego Foundation

Doing business as UCSD Student Run Free Clinic Project

  • Health Service Clinic/Center
  • San Diego, CA
National Provider Identifier
1578965471
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
UC SAN DIEGO FOUNDATION
Doing business as
UCSD Student Run Free Clinic Project
Practice address
1420 3Rd Ave
San Diego, CA 92101-3103
Phone
(858) 534-6160
Fax
(858) 822-3990
NPI assigned
Sep 23, 2014
Last updated
Jan 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
UC SAN DIEGO FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
Dr. Sunny D Smith, MD
Title
Clinic Director
Phone
(858) 534-6160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X CA Primary

Addresses

Primary practice location

1420 3Rd Ave
San Diego, CA 92101-3103

Mailing address

9500 Gilman Dr
La Jolla, CA 92093-0696
Phone (858) 534-6160

Other names 1

  • UCSD Student Run Free Clinic Project Doing business as

National Provider Directory

National Provider Directory
Tax ID family
UC San Diego Foundation3 organizations share this tax ID, including this one
Part of
UC San Diego Foundation

Other organizations with this tax ID 2

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

Locations

1420 3rd Ave
San Diego, CA 92101
Phone (858) 534-6160

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1578965471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930696",
            "telephone_number": "858-534-6160",
            "fax_number": "858-822-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013103",
            "telephone_number": "858-534-6160",
            "fax_number": "858-822-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC SAN DIEGO FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UC SAN DIEGO FOUNDATION",
        "enumeration_date": "2014-09-23",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "858-534-6160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSD Student Run Free Clinic Project",
            "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 Jan 23, 2015; 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.