Healthcare Provider Details
I. General information
NPI: 1366789307
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2013
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23550 HAWTHORNE BLVD #180
TORRANCE CA
90505-4731
US
IV. Provider business mailing address
3701 SKYPARK DR #200
TORRANCE CA
90505-4753
US
V. Phone/Fax
- Phone: 310-301-8707
- Fax: 310-301-8751
- Phone: 310-301-8707
- Fax: 310-301-8751
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
KEI
OYE
Title or Position: VICE CHAIR OF CLINICAL SERVICES
Credential: M.D.
Phone: 310-206-0644