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General NPI Number Information
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NPI Number | 1346303195
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Entity Type | Organization
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Legal Business Name | REGENTS OF UNIV. OF CALIFORNIA DENTAL ANESTHESIA SERVICE
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 10833 LECONTE AVE 53-039 CHS
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City | LOS ANGELES
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State | CA
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Zip | 90095-1668
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Country | US
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Telephone | 310-825-9300
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Fax | 877-352-0109
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE CHS 63-087
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City | LOS ANGELES
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State | CA
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Zip | 90095-1668
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Country | US
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Telephone | 310-266-5982
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Fax | 310-825-7232
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Authorized Official
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Title or Position | ASSOC PROFESSOR
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Name | DR. CHRISTINE L QUINN
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Credential | DDS
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Telephone | 310-206-5982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 60746
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License Number State | CA
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