Organization
REGENTS OF THE UNIVERSITY OF CA
Active
Other names
UCD Nutritional Assesment Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM H MCGOWAN (CFO)
(916) 734-9129
Entity
Organization
Contact information
Practice address
TB 156, DAVIS, CA 95616
(530) 752-2714
Mailing address
4900 BROADWAY, STE 2500, SACRAMENTO, CA 95820-1532
(916) 734-9200
(916) 734-9336
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB58715F
—
CA
Enumeration date
08/24/2005
Last updated
08/22/2020
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