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General NPI Number Information
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NPI Number | 1467592469
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA, IRVINE
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | C380 MEDICAL SCIENCE I
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City | IRVINE
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State | CA
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Zip | 92697-4069
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Country | US
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Telephone | 949-824-5818
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Fax | 949-824-4362
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Provider Business Mailing Address
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Address Line | C240 MEDICAL SCIENCE I
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City | IRVINE
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State | CA
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Zip | 92697-4069
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Country | US
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Telephone | 949-824-5818
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Fax | 949-824-4362
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Authorized Official
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Title or Position | PROFESSOR
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Name | DR. SUDHIR GUPTA
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Credential | M.D., PH.D.
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Telephone | 949-824-5818
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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 | CLF 4904
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License Number State | CA
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