# RADY CHILDREN'S HOSPITAL SAN DIEGO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174907216
- **Authorized official:** ALEXA KRATZE (DEVELOPMENTAL SEVICES DIRECTOR)
- **Authorized official phone:** (858) 966-5829

## Contact information

- **Practice address:** 3020 CHILDRENS WAY \# MC5068, SAN DIEGO, CA 92123-4223
- **Practice address phone:** (858) 966-5829
- **Practice address fax:** (858) 966-5859
- **Mailing address:** 3020 CHILDRENS WAY \# MC5068, SAN DIEGO, CA 92123-4223
- **Mailing address phone:** (858) 966-5829
- **Mailing address fax:** (858) 966-5859

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 283XC2000X | Children's Rehabilitation Hospital | OT15043 | CA | Yes |

## Other

- **Enumeration date:** 07/18/2015
- **Last updated:** 01/30/2025