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General NPI Number Information
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NPI Number | 1932264413
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA REGENTS
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 DICKINSON ST ROOM 203
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City | SAN DIEGO
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State | CA
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Zip | 92103
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Country | US
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Telephone | 619-543-5260
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Fax | 619-543-3565
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Provider Business Mailing Address
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Address Line | 9500 GILMAN DR MAIL CODE 0830
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City | LA JOLLA
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State | CA
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Zip | 92093-0830
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Country | US
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Telephone | 619-543-5260
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Fax | 619-543-3565
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | WILLIAM L NYHAN JR.
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Credential | MD
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Telephone | 619-543-5260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF4102
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License Number State | CA
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