Organization
UCI DEPARTMENT OF UROLOGY
Active
Other names
Regents of the University of California, Irvine
Organization subpart
No
Provider details
NPI number
Authorized official
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) 456-8500
(714) 456-8572
Mailing address
PO BOX 51342, LOS ANGELES, CA 90051-5642
(714) 456-6054
(888) 378-5391
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG7652
RR MEDICARE
CA
05
—
GR0085140
—
CA
01
—
ZZZ54082Z
BLUE SHIELD GRP
CA
Enumeration date
04/28/2006
Last updated
02/26/2020
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