MEDICARE: REGENTS OF THE UNIVERSITY OF CA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CI4127	OTHER	CA	RAILROAD MEDICARE PIN
3	CN4844	OTHER	CA	RAILROAD MEDICARE PIN
4	CR0028	OTHER	CA	RAILROAD MEDICARE PIN
5	DE7275	OTHER	CA	RAILROAD MEDICARE PIN
7	CN4400	OTHER	CA	RAILROAD MEDICARE PIN
8	DA4168	OTHER	CA	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710970736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENTS OF THE UNIVERSITY OF CA

Provider Business Mailing Address
First Line	:	10850 WHITE ROCK RD
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-6044
Country	:	US
Telephone Number	:	916-734-9200
Fax Number	:	916-734-9661

Provider Business Practice Location Address
First Line	:	4860 Y ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:	916-734-8046
Fax Number	:	916-734-2732

Authorized Official
Title or Position	:	VICE PRESIDENT, GOV'T REIMBURSEMENT
Name	:	TAMMY TROVATTEN
Credential	:
Telephone Number	:	916-855-2315

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	05/16/2025

Similar Medicare Providers

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Practice Location Address:

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1033642871 — EILEEN WANG MD
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1942172812 — AMRITPAL KAUR NP
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1629075536 — DR. JULIANNA LANDON BURTON PHARMD
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1740272541 — DR. TIMOTHY WILLIAM CUTLER PHARM.D.
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1629061882 — REGENTS OF THE UNIV OF CA
Practice Location Address:

4860 Y ST
SACRAMENTO, CA
95817-2307

Practice Phone: 916-734-6967
Practice Fax: 916-452-9327

Directions to “REGENTS OF THE UNIVERSITY OF CA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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