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General NPI Number Information
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NPI Number | 1659648202
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA DAVIS
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 2825 J ST SUITE 400
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City | SACRAMENTO
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State | CA
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Zip | 95816-4300
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Country | US
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Telephone | 916-734-4490
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Fax | 916-754-6152
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Provider Business Mailing Address
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Address Line | 451 E. HEALTH SCIENCES DR. ROOM 6323
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City | DAVIS
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State | CA
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Zip | 95616-5270
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Country | US
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Telephone | 530-752-4054
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Fax | 530-754-6391
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Authorized Official
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Title or Position | CHANCELLOR
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Name | DR. LINDA KATEHI
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Credential | PHD
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Telephone | 530-752-2065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | G26076
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License Number State | CA
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