Organization · Type 2 NPI

Rady Children's Hospital San Diego

Skilled Nursing Facility · San Diego, CA

NPI number 1114091055 Active

Practice location

3020 Childrens Way # MC5019
San Diego, CA 92123-4223

Fax (858) 966-8558

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed
Pediatric Skilled Nursing Facility	3140N1450X	080000028 (CA)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

Another provider at this address

Rady Children's Hospital - San DiegoSkilled Nursing Facility San Diego, CA NPI 1376618553

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NPI record

NPI: 1114091055
Entity type: Organization (Type 2)
Issued: Nov 20, 2006
Last updated: Jan 22, 2025
Status: Active
Subpart: Yes of Rady Children's Hospital San Diego

Other names

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Rady Children's Convalescent Hospital · doing business as
Rady Children's Convalescent Hospital · doing business as

Authorized official

Kathleen Marie Cain Carrithers
SR VP & Chief Financial Officer
(858) 966-5824

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114091055

Rady Children's Hospital San Diego's National Provider Identifier is 1114091055, issued on Nov 20, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in San Diego, CA. The record was last updated on Jan 22, 2025.