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NPI Code Detail

MEDICARE: REGENTS OF THE UNIVERSITY OF CALIFORNIA

MEDICARE: REGENTS OF THE UNIVERSITY OF CALIFORNIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083694616
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGENTS OF THE UNIVERSITY OF CALIFORNIA
Provider Business Mailing Address
First Line : 4900 BROADWAY
Second Line : STE 1200
City : SACRAMENTO
State : CA
Zip : 95820-1532
Country : US
Telephone Number : 916-734-9654
Fax Number : 916-736-1419
Provider Business Practice Location Address
First Line : 8110 LAGUNA BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-7904
Country : US
Telephone Number : 916-683-3950
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : ALLEN D HALL
Credential :
Telephone Number : 916-734-8203
Provider Enumeration Date : 01/19/2006
Last Update Date : 10/09/2023

Similar Medicare Providers

1043293079 — DR. RADHIKA NANDUR BUKKAPATNAM M.D.
Practice Location Address:
8110 LAGUNA BLVD
ELK GROVE, CA
95758-7904
Practice Phone: 916-683-3950
Practice Fax: 916-683-3970
1760466924 — DR. ALLEN DIALLO HALL M.D.
Practice Location Address:
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95758-7904
Practice Phone: 916-683-3955
Practice Fax:
1942285309 — NANETTE JORDAN PATRON PA
Practice Location Address:
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Practice Fax: 916-683-3972
1295710390 — JOHN GREGORY BIAS M.D.
Practice Location Address:
8110 LAGUNA BLVD
ELK GROVE, CA
95758-7904
Practice Phone: 916-683-3955
Practice Fax:
1790761054 — BARBARA J SMITH-NASH M.D.
Practice Location Address:
8110 LAGUNA BLVD
ELK GROVE, CA
95758-7904
Practice Phone: 916-683-3955
Practice Fax:
1861418915 — NICOLE MAREK FARO MD
Practice Location Address:
8110 LAGUNA BLVD
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95758-7904
Practice Phone: 916-683-3955
Practice Fax: 916-683-3972

Directions to “REGENTS OF THE UNIVERSITY OF CALIFORNIA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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