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Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCI, Dept of Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA A KOCH (PROVIDER RELATIONS)
(714) 456-8068
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-2986
(714) 456-2979
Mailing address
PO BOX 54509, LOS ANGELES, CA 90054-0509
(714) 456-2986
(714) 456-2979
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPS001170
—
CA
Enumeration date
04/26/2013
Last updated
04/26/2013
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