Basic Information
| Provider Information | |||||||||
| NPI: | 1073817631 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3851 ROSECRANS ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921103134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196928200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3851 ROSECRANS ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921103134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196928200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2010 | ||||||||
| LastUpdateDate: | 12/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | AGUIRRE | ||||||||
| AuthorizedOfficialFirstName: | ALFREDO | ||||||||
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| AuthorizedOfficialTitleorPosition: | DEPUTY DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6195632711 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COUNTY OF SAN DIEGO | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | CA | Y | Hospitals | Psychiatric Hospital |
No ID Information.