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General NPI Number Information
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NPI Number | 1699877621
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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 | 09/01/2006
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 200 W ARBOR DR
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City | SAN DIEGO
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State | CA
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Zip | 92103-9000
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Country | US
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Telephone | 800-926-8273
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Fax | 888-539-8781
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Provider Business Mailing Address
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Address Line | FILE 57326
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City | LOS ANGELES
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State | CA
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Zip | 90074-2410
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Country | US
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Telephone | 800-926-8273
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, REVENUE CYCLE & OPERATION
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Name | MR. MICHAEL DENNIS PRICE
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Credential |
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Telephone | 858-249-6752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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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 | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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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 | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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