Organization
REGENTS OF THE UNIVERSITY OF CA-UCSD AMBULATORY CARE PHARMACY
Active
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSD MEDICAL GROUP
Other names
UCSD MEDICAL GROUP PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSD MEDICAL GROUP
Authorized official
MR. GARY HAGNEY RPH (DIRECTOR UCSD AMCARE PHARMACY)
(619) 543-6194
Entity
Organization
Contact information
Practice address
330 LEWIS ST, 2ND FLR, SAN DIEGO, CA 92103-2108
(619) 471-9235
(619) 471-9236
Mailing address
200 W ARBOR DR, MAIL CODE 8765, SAN DIEGO, CA 92103-9000
(619) 543-6194
(619) 543-5829
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHE37896
CA
3336C0002X
Clinic Pharmacy
PHE37896
CA
3336C0003X
Community/Retail Pharmacy
PHE37896
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0546412
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
GU028B
MEDICARE PART B
CA
05
—
PHB378960
—
CA
Enumeration date
07/22/2006
Last updated
06/10/2013
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