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Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE C. CHAN (AUTHORIZED)
(619) 543-6463
Entity
Organization
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 576-1700
Mailing address
FILE NO 54826, LOS ANGELES, CA 90074-0001
(888) 486-4349
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0069870
—
CA
Enumeration date
10/01/2007
Last updated
08/06/2020
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