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1427176221

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
1	207ND0101X	MOHS-Micrographic Surgery Physician
2	207ND0900X	Dermatopathology Physician
3	207NI0002X	Clinical & Laboratory Dermatological Immunology Physician
4	207NP0225X	Pediatric Dermatology Physician
5	207NS0135X	Procedural Dermatology Physician
6	207N00000X	Dermatology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CQ4024	OTHER	CA	RAILOROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	ZZZ09217Z	OTHER	CA	BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	ZZZ09218Z	OTHER	CA	BLUE SHIELD
6	ZZZ69123Z	OTHER	CA	BLUE SHIELD
7	ZZZP3708Z	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1427176221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENTS OF THE UNIVERSITY OF CALIFORNIA

Provider Business Mailing Address
First Line	:	FILE 57326
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90074-2410
Country	:	US
Telephone Number	:	800-926-8273
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W ARBOR DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-9000
Country	:	US
Telephone Number	:	800-926-8273
Fax Number	:	888-539-8781

Authorized Official
Title or Position	:	DIRECTOR, REVENUE CYCLE & OPERATION
Name	:	MR. MICHAEL DENNIS PRICE
Credential	:
Telephone Number	:	858-249-6752

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	04/25/2024

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

Language	Start Address	Practice Location

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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