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General NPI Number Information
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NPI Number | 1689692303
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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 | 07/18/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE # A0-156C
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-825-0834
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Fax | 310-794-2198
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE 200 MEDICAL PLAZA, SUITE 460
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City | LOS ANGELES
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State | CA
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Zip | 90095-1668
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Country | US
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Telephone | 310-825-3442
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Fax | 310-794-7933
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Authorized Official
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Title or Position | CLM PROFESSOR
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Name | DR. WAYNE OZAKI
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Credential | DDS
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Telephone | 310-825-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 24545
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License Number State | CA
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