Organization
UNIVERSITY OF CALIFORNIA IRVINE
Active
Parent organization
UNIVERSITY OF CALIFORNIA IRVI
Other names
UCI Health Lakewood
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF CALIFORNIA IRVI
Authorized official
RANDOLPH PERSEVERANCE SIWABESSY (VICE PRESIDENT AND CHIEF FINANCIAL)
(714) 456-5180
Entity
Organization
Contact information
Practice address
3700 SOUTH ST, LAKEWOOD, CA 90712-1419
(562) 531-2550
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
282N00000X
General Acute Care Hospital
Primary
930000046
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000405
HUMANA
—
01
—
017523-0001
PACIFICARE OF CALIFORNIA
—
01
—
050581B000000
SECTION 1011
—
01
—
272609
COVENTRY HEALTH CARE KANS
—
01
—
684778260
AETNA US HEALTHCARE
—
01
—
8091
HEALTH NET
—
05
—
HSC30581G
—
CA
05
—
HSP40581G
—
CA
01
—
ZZZA1971Z
BS OF CALIFORNIA
—
Enumeration date
07/05/2006
Last updated
07/18/2024
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