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Organization
REGENTS OF THE UNIV OF CA
Active
Organization
REGENTS OF THE UNIV OF CA
Active
Parent organization
REGENTS OF THE UNIV OF CA
Other names
Regents UCDPBG Optometry
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENTS OF THE UNIV OF CA
Authorized official
MR. JAMES D KIRK MD (CMO)
(916) 734-1166
Entity
Organization
Contact information
Practice address
4860 Y ST, SACRAMENTO, CA 95817
(916) 734-6967
(916) 452-9327
Mailing address
4900 BROADWAY, SUITE 2600, SACRAMENTO, CA 95820
(916) 734-9200
(916) 734-9336
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD003030
—
CA
Enumeration date
07/17/2006
Last updated
03/21/2014
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