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General NPI Number Information
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NPI Number | 1407825128
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Entity Type | Organization
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Legal Business Name | UC REGENTS UCLA DMPG DERMATOLOGY
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 1131 WILSHIRE BLVD UC REGENTS UCLA DMPG DERMATOLOGY SUITE 200
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City | SANTA MONICA
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State | CA
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Zip | 90401-2061
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Country | US
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Telephone | 310-917-3376
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24DD5 WESTWOOD STATION
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 310-301-8708
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Fax | 310-301-8751
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Authorized Official
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Title or Position | VICE CHAIR OF CLINICAL SERVICES
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Name | DR. ROBERT K OYE
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Credential | MD
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Telephone | 310-206-0644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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