1750374815 NPI number — REGENTS OF THE UNIV OF CA

Table of content: (NPI 1750374815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750374815 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:
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:
1750374815
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:
4501 X 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:
95817-2229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-6930
Provider Business Practice Location Address Fax Number:
916-734-6666
Provider Enumeration Date:
08/24/2005

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: 207VX0201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CN4400 . 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: GR002104H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CR0028 . 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: CI4127 . 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: CN4844 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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