Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
Regents UCDMG Elk Grove
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN D HALL (MEDICAL DIRECTOR)
(916) 734-8203
Entity
Organization
Contact information
Practice address
8110 LAGUNA BLVD, ELK GROVE, CA 95758-7904
(916) 683-3950
Mailing address
4900 BROADWAY, STE 1200, SACRAMENTO, CA 95820-1532
(916) 734-9654
(916) 736-1419
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0063732
—
CA
Enumeration date
01/19/2006
Last updated
10/09/2023
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