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General NPI Number Information
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NPI Number | 1952308363
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Entity Type | Organization
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Legal Business Name | REGENTS UNIV OF CALIF LOS ANGELES
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 150 UCLA MEDICAL PLAZA
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-267-9308
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Fax | 310-267-3516
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Provider Business Mailing Address
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Address Line | 10920 WILSHIRE BLVD STE 1700
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City | LOS ANGELES
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State | CA
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Zip | 90024-6502
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Country | US
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Telephone | 310-948-7371
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TAMMY LEHR WALLACE
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Credential |
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Telephone | 310-267-9307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 930000204
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License Number State | CA
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