# REGENTS OF THE UNIVERSITY OF CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UCLA Orthopedic Surgery Med Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528179793
- **Authorized official:** KATHERINE HALE (DIRECTOR OF FINANCE)
- **Authorized official phone:** (310) 301-5311

## Contact information

- **Practice address:** 100 MEDICAL PLAZA SUITE 755, LOS ANGELES, CA 90095-0001
- **Practice address phone:** (424) 206-2386
- **Mailing address:** 5767 W CENTURY BLVD, STE 400, LOS ANGELES, CA 90045-5631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XP3100X | Pediatric Orthopaedic Surgery Physician | — | NULL | — |
| 207XP3100X | Pediatric Orthopaedic Surgery Physician | — | — | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | — | NULL | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | — | — | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | NULL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | NULL | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | — | — |
| 225100000X | Physical Therapist | — | CA | — |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |
| 2251X0800X | Orthopedic Physical Therapist | — | NULL | — |
| 2251X0800X | Orthopedic Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 06/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0065850 | — | CA |