MEDICARE: REGENTS OF THE UNIV 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
1	282N00000X	General Acute Care Hospital	930000146	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4802080001	OTHER	CA	DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS AND SUPPLIES
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427055839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENTS OF THE UNIV OF CALIFORNIA

Provider Business Mailing Address
First Line	:	10920 WILSHIRE BLVD
Second Line	:	SUITE 1700
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-6502
Country	:	US
Telephone Number	:	310-948-7371
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 16TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1249
Country	:	US
Telephone Number	:	310-267-9308
Fax Number	:	310-267-3516

Authorized Official
Title or Position	:	CFO
Name	:	TAMMY LEHR WALLACE
Credential	:
Telephone Number	:	310-267-9307

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/04/2025

Similar Medicare Providers

1023313392 — MAUREEN ELIZABETH MCMENAMY N.P.
Practice Location Address:

1250 16TH ST # C2304
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90404-1249

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1295355816 — DR. TYLER PEMBROKE JACKSON MD
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1568468528 — DR. UMESH THAKURDAS BHAGIA MD
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1250 16TH ST
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1689657579 — DEBORAH KRAKOW MD
Practice Location Address:

1250 16TH ST STE 2100
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1083681258 — DR. JOHN PATRICK WHELAN MD PHD
Practice Location Address:

1250 16TH ST # C2304
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1497704738 — JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA, INC.
Practice Location Address:

1250 16TH ST , EMERGENCY DEPARTMENT
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Directions to “REGENTS OF THE UNIV OF CALIFORNIA ” Practice Location

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