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General NPI Number Information
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NPI Number | 1386895068
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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 | 10/01/2008
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 3146 TUPPER HALL TUPPER HALL, HEALTH SCIENCES DRIVE
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City | DAVIS
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State | CA
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Zip | 95616
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Country | US
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Telephone | 530-752-1757
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Fax | 530-752-8692
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Provider Business Mailing Address
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Address Line | 10545 ARMSTRONG AVE STE 1200
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City | MATHER
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State | CA
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Zip | 95655-4101
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Country | US
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Telephone | 916-734-9112
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Fax | 916-734-9661
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Authorized Official
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Title or Position | DIRECTOR, GOVERNMENT REIMBURSEMENT
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Name | TAMMY TROVATTEN
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Credential |
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Telephone | 916-734-9112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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