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Organization
UC REGENTS
Active
Organization
UC REGENTS
Active
Parent organization
UC REGENTS
Other names
UCI HEALTH-FOUNTAIN VALLEY IMAGING-WARNER AVE, UCI Health-Fountain Valley Imaging-Warner
Organization subpart
Yes
Provider details
NPI number
Legal business name
UC REGENTS
Authorized official
RANDOLPH PERSEVERANCE SIWABESSY (VICE PRESIDENT AND CHIEF FINANCIAL)
(714) 456-5180
Entity
Organization
Contact information
Practice address
11190 WARNER AVE, SUITE 110, FOUNTAIN VALLEY, CA 92708-4019
(714) 456-5676
(714) 456-6216
Mailing address
1500 S DOUGLASS RD, SUITE 200, RT 183, ANAHEIM, CA 92806-6911
(714) 456-6245
(714) 456-6715
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
01/25/2012
Last updated
05/21/2024
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