Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCSD Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DENNIS PRICE (DIRECTOR, REVENUE CYCLE & OPERATION)
(858) 249-6752
Entity
Organization
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-2410
(800) 926-8273
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CQ4024
RAILOROAD MEDICARE
CA
05
—
GR0013562
—
CA
01
—
ZZZ09217Z
BLUE SHIELD
CA
01
—
ZZZ09218Z
BLUE SHIELD
CA
01
—
ZZZ69123Z
BLUE SHIELD
CA
01
—
ZZZP3708Z
BLUE SHIELD
CA
05
—
ZZZP3708Z
—
CA
Enumeration date
03/27/2007
Last updated
04/25/2024
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