UC San Diego Foundation

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

1561 Thomas Ave
San Diego, CA 92109-4346

Phone

(858) 534-6160

Fax

(858) 822-3990

NPI assigned

Jan 23, 2015

Last updated

Jan 23, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

UC SAN DIEGO FOUNDATIONAs reported in NPPES

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

Addresses

Other names 1

• UCSD Student Run Free Clinic Project Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• UC San Diego Foundation

  dba UCSD Student Run Free Clinic Project

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1578965471
  NPD tax ID
• UC San Diego Foundation

  dba UCSD Student Run Free Clinic Project

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1639569098
  NPD tax ID

Locations

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1598155962",
    "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": "1561 THOMAS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094346",
            "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": "2015-01-23",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSD Student Run Free Clinic Project",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• U.S. Spine & Sport Verna Chiropractic, Inc.
• Pat Ubarieke
• UC San Diego
• UC San Diego Department of Anesthesiology
• UC San Diego Foundation (UCSD Student Run Free Clinic Project)
• UC San Diego Foundation (UCSD Student Run Free Clinic Project)
• UC San Diego Health - Monica Perlman Clinic
• UC San Diego Health Accountable Care Network, Inc.
• UC San Diego Health Community Group
• UC San Diego Health System

• Health Service Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Health Service Clinic/Center in California

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.