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General NPI Number Information
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NPI Number | 1568431310
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Entity Type | Organization
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Legal Business Name | THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 200 MEDICAL PLZ SUITE 450,465
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-206-8694
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Fax | 310-794-7005
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90074-5737
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Country | US
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Telephone | 310-301-5200
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATHIE HALE
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Credential |
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Telephone | 310-301-5311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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