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General NPI Number Information
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NPI Number | 1215081005
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA, DAVIS
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4860 Y ST SUITE 0100
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City | SACRAMENTO
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State | CA
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Zip | 95817-2307
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Country | US
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Telephone | 916-734-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 4860 Y ST SUITE 3700
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City | SACRAMENTO
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State | CA
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Zip | 95817-2307
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | DR. MASUD SEYAL
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Credential | MD
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Telephone | 916-734-8416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 7921
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License Number State | CA
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