1992831655 NPI number — 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 1992831655 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:
Provider Other Organization Name Type Code:
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:
1992831655
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10833 LE CONTE AVE BOX 951668
Provider Second Line Business Mailing Address:
RM A0-125CHS
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90095-1668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-825-8879
Provider Business Mailing Address Fax Number:
310-825-2124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10833 LE CONTE AVE BOX 951668
Provider Second Line Business Practice Location Address:
RM A0-125CHS
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-825-8879
Provider Business Practice Location Address Fax Number:
310-794-9723
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YOUNAI
Authorized Official First Name:
FARIBA
Authorized Official Middle Name:
SIMHAI
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
310-825-8879

Provider Taxonomy Codes

  • Taxonomy code: 1223D0001X , with the licence number:  2075 , 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)





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