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General NPI Number Information
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NPI Number | 1033102934
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIV OF CA
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 2221 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-1418
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Country | US
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Telephone | 916-734-2715
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Fax | 916-734-0100
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Provider Business Mailing Address
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Address Line | 10850 WHITE ROCK RD
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-6044
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Country | US
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Telephone | 916-734-9200
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Fax | 916-734-9661
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Authorized Official
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Title or Position | VICE PRESIDENT, GOV'T REIMBURSEMENT
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Name | TAMMY TROVATTEN
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Credential |
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Telephone | 916-855-2315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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