Healthcare Provider Details

I. General information

NPI: 1598786576
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9000
US

IV. Provider business mailing address

PO BOX 743475
LOS ANGELES CA
90074-3475
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-3279
  • Fax: 619-543-7549
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberHPE3481
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberHPE3481
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberHPE3481
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberHPE3481
License Number StateCA

VIII. Authorized Official

Name: TRACEY SPANGENBERG
Title or Position: DIRECTOR
Credential:
Phone: 619-543-6194