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Organization
UC REGENTS
Active
Organization
UC REGENTS
Active
Other names
UCI Radiology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA COPEN (PROVIDER ENROLLMENT MANAGER)
(714) 456-6227
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8068
(714) 456-2979
Mailing address
PO BOX 31001-2482, PASADENA, CA 91110-2482
(714) 456-8026
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD6546
RAILROAD MEDICARE GROUP
CA
01
—
GR0077110
MEDI-CAL GROUP #
CA
01
—
HW13931
MEDICARE GROUP #
—
01
—
ZZZ22566Z
BLUE SHIELD GROUP #
CA
01
—
ZZZP3012Z
BLUE SHIELD GROUP #
CA
Enumeration date
05/04/2006
Last updated
05/22/2025
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