Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UC Irvine Pathology Services
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA COPEN (PROVIDER ENROLLMENT MANAGER)
(714) 456-6227
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868
(714) 456-6411
(714) 456-5873
Mailing address
PO BOX 31001-2482, PASADENA, CA 91110-2482
(714) 456-8835
(714) 456-6248
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0579200
MEDICARE PTAN
CA
05
—
LAB00975F
—
CA
01
—
ZZZP3016Z
BLUE SHIELD
CA
Enumeration date
02/05/2007
Last updated
05/22/2025
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