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General NPI Number Information
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NPI Number | 1093762585
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 800 N MAIN ST
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City | SANTA ANA
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State | CA
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Zip | 92701-3576
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Country | US
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Telephone | 714-456-8068
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Fax | 714-456-3765
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Provider Business Mailing Address
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Address Line | PO BOX 6370
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City | ORANGE
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State | CA
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Zip | 92863-6370
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Country | US
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Telephone | 714-456-8068
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Fax | 714-456-3765
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CECILIA FLORIO
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Credential | MD
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Telephone | 714-456-8068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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