Healthcare Provider Details

I. General information

NPI: 1053556688
Provider Name (Legal Business Name): THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N FRESNO ST
FRESNO CA
93701-2302
US

IV. Provider business mailing address

155 N. FRESNO STREET
FRESNO CA
93701
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-6440
  • Fax: 559-499-6441
Mailing address:
  • Phone: 559-499-6440
  • Fax: 559-499-6441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOAN VORIS
Title or Position: ASSOCIATE DEAN
Credential:
Phone: 559-499-6427