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General NPI Number Information
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NPI Number | 1427156454
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Entity Type | Organization
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Legal Business Name | REGENTS UNIV OF CALIF LOS ANGELES
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 200 MEDICAL PLAZA SUITE 426
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City | LOS ANGELES
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State | CA
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Zip | 90095
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Country | US
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Telephone | 310-794-7458
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Fax | 310-794-7463
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Provider Business Mailing Address
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Address Line | PHARMACY BUSINESS OFFICE 757 WESTWOOD PLAZA, ROOM B504E
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City | LOS ANGELES
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State | CA
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Zip | 90095-7423
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Country | US
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Telephone | 310-794-7458
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Fax | 310-794-7463
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Authorized Official
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Title or Position | CFO UCLA HOSPITAL SYSTEM
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Name | MR. RONALD A DAVIS
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Credential |
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Telephone | 310-794-8627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHE40975
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License Number State | CA
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