Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSD AMBULATORY CARE PHARMACY
Active
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSDMG
Other names
THE EDITH & WILLIAM PERLMAN ACC PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA-UCSDMG
Authorized official
MR. GARY HAGNEY RPH (DIRECTOR UCSD AMCARE PHARMACY)
(619) 543-6194
Entity
Organization
Contact information
Practice address
9350 CAMPUS POINT DR, LA JOLLA, CA 92037-1300
(858) 657-8610
(858) 657-8621
Mailing address
200 W ARBOR DR, MAIL CODE 8765, SAN DIEGO, CA 92103-9001
(619) 543-6194
(619) 543-5829
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHE39292
CA
3336C0002X
Clinic Pharmacy
PHE39292
CA
3336C0003X
Community/Retail Pharmacy
PHE39292
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0542589
NCPDP
CA
01
—
GU028A
MEDICARE PART B PTAN
CA
05
—
PHB392920
—
CA
Enumeration date
07/22/2006
Last updated
06/10/2013
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