| Scripps Mercy Hospital Behavioral Health Unit | |
|
4077 5th Ave San Diego CA 92103-2105 | |
| (619) 260-7101 | |
| Not Available |
| Full Name | Scripps Mercy Hospital Behavioral Health Unit |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 4077 5th Ave, San Diego, California |
| Authorized Official Name and Position | Brett Tande (EVP/CFO) |
| Authorized Official Contact | 8586787227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scripps Mercy Hospital Behavioral Health Unit 10790 Rancho Bernardo Rd San Diego CA 92127-5705 Ph: (858) 657-4218 | Scripps Mercy Hospital Behavioral Health Unit 4077 5th Ave San Diego CA 92103-2105 Ph: (619) 260-7101 |
| NPI Number | 1154308005 |
|---|---|
| Provider Enumeration Date | 12/30/2005 |
| Last Update Date | 07/11/2022 |
| Certification Date | 07/11/2022 |
| Medicare PECOS PAC ID | 9234033853 |
|---|---|
| Medicare Enrollment ID | O20071219000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154308005 | NPI | - | NPPES |
| 050077 | Other | BLUE CROSS | |
| HSM30077G | Other | MEDICAL IN PATIENT | |
| HSM30077G | Other | MEDICAL HMO IN PATIENT | |
| 6152170 | Other | AETNA | |
| ZZT40077G | Other | MEDICAL HMO OUT PATIENT | |
| 090000074 | Other | STATE LICENSE | |
| ZZZA3708Z | Other | BLUE SHIELD | |
| ME | Other | KAISER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 050000074 (California) | Primary |
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