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Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCLA Integrated Provider Network
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE HALE (FINANCIAL OFFICER)
(310) 301-5311
Entity
Organization
Contact information
Practice address
714 TIVERTON AVE RM 10-157, LOS ANGELES, CA 90095-8361
(310) 825-8083
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
08/14/2025
Last updated
10/13/2025
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