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NPI Code Detail

MEDICARE: REGENTS OF THE UNIVERSITY OF CA

MEDICARE: REGENTS OF THE UNIVERSITY OF CA
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
1261QP3300XPain 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
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528051547
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGENTS OF THE UNIVERSITY OF CA
Provider Business Mailing Address
First Line : 4900 BROADWAY
Second Line : SUITE 2600
City : SACRAMENTO
State : CA
Zip : 95820-1532
Country : US
Telephone Number : 916-734-9200
Fax Number : 916-734-9661
Provider Business Practice Location Address
First Line : 4860 Y ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2307
Country : US
Telephone Number : 916-734-6824
Fax Number : 916-734-6827
Authorized Official
Title or Position : CFO
Name : MR. WILLIAM H MCGOWAN
Credential :
Telephone Number : 916-734-9129
Provider Enumeration Date : 08/24/2005
Last Update Date : 03/10/2008

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Practice Fax:
1629061882 — REGENTS OF THE UNIV OF CA
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4860 Y ST
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95817-2307
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1710970736 — REGENTS OF THE UNIVERSITY OF CA
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1437142452 — REGENTS OF THE UNIV OF CA
Practice Location Address:
4860 Y ST
SACRAMENTO, CA
95817-2307
Practice Phone: 916-734-8046
Practice Fax: 916-734-5495

Directions to “REGENTS OF THE UNIVERSITY OF CA ” 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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