# REGENTS OF THE UNIV OF CA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Regents/UCDPBG/SUR CARDI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609869627
- **Authorized official:** TAMMY TROVATTEN (VICE PRESIDENT, GOV'T REIMBURSEMENT)
- **Authorized official phone:** (916) 855-2315

## Contact information

- **Practice address:** 2221 STOCKTON BLVD, SACRAMENTO, CA 95817-1418
- **Practice address phone:** (916) 734-7313
- **Practice address fax:** (916) 734-8487
- **Mailing address:** 10850 WHITE ROCK RD, RANCHO CORDOVA, CA 95670-6044
- **Mailing address phone:** (916) 734-9200
- **Mailing address fax:** (916) 734-9661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2005
- **Last updated:** 05/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CI4127 | RAILROAD MEDICARE PIN | CA |
| 01 | — | CN4400 | RAILROAD MEDICARE PIN | CA |
| 01 | — | CN4844 | RAILROAD MEDICARE PIN | CA |
| 01 | — | CR0028 | RAILROAD MEDICARE PIN | CA |
| 01 | — | DA4168 | RAILROAD MEDICARE PIN | CA |
| 01 | — | DE7275 | RAILROAD MEDICARE PIN | CA |
| 05 | — | GNP000070 | — | CA |
| 05 | — | GR002104W | — | CA |