Healthcare Provider Details
I. General information
NPI: 1467467340
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10833 LE CONTE AVE CHS 10-157
LOS ANGELES CA
90095-3075
US
IV. Provider business mailing address
10833 LE CONTE AVE C145 A3-030
LOS ANGELES CA
90095-1668
US
V. Phone/Fax
- Phone: 310-794-1929
- Fax: 310-206-5302
- Phone: 310-825-2124
- Fax: 310-206-5302
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHERWIN
ARMAN
Title or Position: ASSOC PROFESSOR
Credential: DDS
Phone: 310-825-2124