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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