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Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCLA Entertainment Ind MedGrp
Organization subpart
No
Provider details
NPI number
Authorized official
KATHIE HALE (CHIEF FINANCIAL OFFICER)
(310) 301-5311
Entity
Organization
Contact information
Practice address
1000 FLOWER ST, GLENDALE, CA 91201-3007
(818) 659-5000
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 301-8708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
CA
Other
Enumeration date
02/27/2014
Last updated
11/19/2020
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