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General NPI Number Information
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NPI Number | 1700978780
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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 | 09/28/2006
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 100 UCLA MEDICAL PLAZA STE 350
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 310-794-5750
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Fax | 310-208-0786
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE
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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 | 310-794-5750
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Fax | 310-208-0786
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MICHELLE FELIX
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Credential |
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Telephone | 310-794-5750
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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 | 2026
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 2029
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2021
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2024
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2023
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2021
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2021
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License Number State | CA
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