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General NPI Number Information
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NPI Number | 1497415343
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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 | 12/20/2021
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 9610 RIDGEHAVEN CT STE C
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City | SAN DIEGO
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State | CA
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Zip | 92123-5603
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Country | US
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Telephone | 619-543-7453
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Fax |
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Provider Business Mailing Address
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Address Line | 9435 MEDICAL CENTER DRIVE
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | LORI DONALDSON
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Credential |
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Telephone | 619-543-6613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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