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General NPI Number Information
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NPI Number | 1790179539
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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 | 03/18/2015
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 6699 ALVARADO RD SUITE 2100
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City | SAN DIEGO
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State | CA
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Zip | 92120-5244
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Country | US
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Telephone | 619-229-3920
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 740511
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City | LOS ANGELES
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State | CA
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Zip | 90074-0511
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Country | US
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Telephone | 619-229-3920
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | JOHN DUNCAN CAMPBELL
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Credential |
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Telephone | 619-543-3982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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