Organization
REGENTS OF THE UNIVERSITY OF CLAIFORNIA UNIV NEURSCIENCES
Active
Organization
REGENTS OF THE UNIVERSITY OF CLAIFORNIA UNIV NEURSCIENCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UCI HEALTH PROVIDER RELATIONS (UPS PROVIDER RELATIONS)
(714) 456-2986
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868
(714) 456-8068
(714) 456-3765
Mailing address
PO BOX 31001-2450, PASADENA, CA 91110-2450
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS4851
RAILROAD MEDICARE GROUP
CA
01
—
GR0040280
MEDI-CAL GROUP #
CA
01
—
ZZZ18123Z
BLUE SHIELD GROUP #
CA
Enumeration date
05/04/2006
Last updated
05/07/2019
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