# UCR HEALTH- PLASTIC & RECONSTRUCTIVE SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** REGENTSOF THE UNIVERSITY OF CALIFORNIA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659744175
- **Legal business name:** REGENTSOF THE UNIVERSITY OF CALIFORNIA
- **Authorized official:** DR. JOHN HEYDT M.D. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (714) 456-2986

## Contact information

- **Practice address:** 10694 MAGNOLIA AVE, RIVERSIDE, CA 92505-1816
- **Practice address phone:** (951) 827-7587
- **Practice address fax:** (951) 402-2802
- **Mailing address:** PO BOX 31001-2130, PASADENA, CA 91110-2130
- **Mailing address phone:** (213) 412-1973
- **Mailing address fax:** (213) 412-1981

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2015
- **Last updated:** 11/05/2015