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General NPI Number Information
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NPI Number | 1194089458
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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 | 07/01/2012
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Last Update Date | 07/01/2012
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Provider Practice Location Address
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Address Line | 4610 X ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-2200
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Country | US
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Telephone | 916-762-0779
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Fax |
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Provider Business Mailing Address
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Address Line | 4610 X ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-2200
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Country | US
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Telephone | 916-762-0779
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Fax |
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Authorized Official
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Title or Position | CLERKSHIP COORDINATOR
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Name | CONNIE FREEMAN-ROWLAND
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Credential |
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Telephone | 916-734-2356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number |
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License Number State |
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