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General NPI Number Information
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NPI Number | 1184608812
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Entity Type | Organization
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Legal Business Name | UC DAVIS
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4150 V ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone | 916-734-8583
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 V ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone | 916-734-8583
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Fax |
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Authorized Official
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Title or Position | ASSISTANT PROFESSOR
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Name | DR. WILLIAM H. MCGOWAN
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Credential | M.D.
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Telephone | 916-734-8583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | A54861
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License Number State | CA
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