1861612442 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA

Table of content: (NPI 1861612442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861612442 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
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:
UC DAVIS MEDICAL CENTER
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:
1861612442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4900 BROADWAY
Provider Second Line Business Mailing Address:
SUITE 2800
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95820-1532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-734-9331
Provider Business Mailing Address Fax Number:
916-734-9336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2825 50TH 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:
95817-2308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-703-0313
Provider Business Practice Location Address Fax Number:
916-703-0243
Provider Enumeration Date:
04/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SIEFKIN
Authorized Official First Name:
ALLAN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
MEDICAL DIRECTOR FOR HOSPITAL
Authorized Official Telephone Number:
916-734-9331

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  352217 , 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)

  • Identifier: 352217 . This is a "REGISTERED NURSING" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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