San Diego Rehab

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SAN DIEGO REHAB

Practice address

430 Nutmeg St Ste 200
San Diego, CA 92103-6261

Phone

(310) 343-8684

NPI assigned

Jul 24, 2024

Last updated

Aug 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Young

Title

Manager

Phone

(310) 343-8684

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1639907272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NUTMEG ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 NUTMEG ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036261",
            "telephone_number": "310-343-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-343-8684"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Diego Psychotherapy Services (SDPS)
• San Diego Pulmonary and Critical Care Medical Group Inc.
• San Diego Regional Head & Neck Center
• San Diego Regional Health Information Exchange (San Diego Health Connect)
• San Diego Regional P.E.T. Center, LLC
• San Diego Rehab and Fitness
• San Diego Rescue Mission
• San Diego Rescue Mission
• San Diego Second Chance Program
• San Diego Second Chance Program

• Substance Use Disorder Rehabilitation Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.