1437142692 NPI number — REGENTS OF THE UNIV OF CA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437142692 NPI number — REGENTS OF THE UNIV OF CA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIV OF CA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REGENTS UCDPBG IM PULMON
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437142692
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10850 WHITE ROCK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO CORDOVA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95670-6044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-734-9200
Provider Business Mailing Address Fax Number:
916-734-9661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2825 J ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95816-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-0779
Provider Business Practice Location Address Fax Number:
916-734-0804
Provider Enumeration Date:
08/23/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SADRO
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
916-703-5009

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CR0028 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GR002104T , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CI4127 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CN4844 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DE7275 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DA4168 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GNP000070 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CN4400 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".