Healthcare Provider Details

I. General information

NPI: 1154479723
Provider Name (Legal Business Name): THE REGENTS OF THE UNIVERSITY OF CALIFORNIA-IRVINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S BLDG 1
ORANGE CA
92868
US

IV. Provider business mailing address

PO BOX 31001-2482
PASADENA CA
91110-2482
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-7002
  • Fax: 855-209-8413
Mailing address:
  • Phone: 714-456-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: SYLVIA COPEN
Title or Position: PROVIDER ENROLLMENT MANAGER
Credential:
Phone: 714-456-6227