1225380827 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN DIEGO

Table of content: ROBERT DANIEL NICHOLAS III CRNA (NPI 1366012361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225380827 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN DIEGO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN DIEGO
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:
6
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:
1225380827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 ARBOR DR
Provider Second Line Business Mailing Address:
MC 0851
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92103-2007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-543-7795
Provider Business Mailing Address Fax Number:
619-543-7013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 ARBOR DR
Provider Second Line Business Practice Location Address:
MC 0851
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-7795
Provider Business Practice Location Address Fax Number:
619-543-7013
Provider Enumeration Date:
10/05/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SAXENA
Authorized Official First Name:
SANJAYA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
619-543-6250

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com