Organization
REGENTS OF THE UNIV OF CA
Active
Organization
REGENTS OF THE UNIV OF CA
Active
Other names
UCD Dermatopathology Lab
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY TROVATTEN (VICE PRESIDENT, GOV'T REIMBURSEMENT)
(916) 855-2315
Entity
Organization
Contact information
Practice address
3301 C ST STE 1413, SACRAMENTO, CA 95816-3300
(916) 734-6373
(916) 734-6793
Mailing address
10850 WHITE ROCK RD, RANCHO CORDOVA, CA 95670-6044
(916) 734-9200
(916) 734-9336
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI4127
RAILROAD MEDICARE PIN
CA
05
—
LAB95787F
—
CA
Enumeration date
10/13/2005
Last updated
05/16/2025
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