1194014613 NPI number — THE REGENTS OF THE UNIVERSITY OF CALIFORNIA

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 1194014613 NPI number — THE REGENTS OF THE UNIVERSITY OF CALIFORNIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
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:
SANTA MONICA-UCLA MEDICAL CENTER AND ORTHOPAEDIC HOSPITAL
Provider Other Organization Name Type Code:
3
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:
1194014613
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1250 16TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA MONICA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90404-1249
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-319-4338
Provider Business Mailing Address Fax Number:
310-319-4821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 16TH ST
Provider Second Line Business Practice Location Address:
1 FLOOR EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90404-1249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-319-4338
Provider Business Practice Location Address Fax Number:
310-319-4821
Provider Enumeration Date:
04/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
STATON
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
ALVIN
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
310-267-9308

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  930000146 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com