Organization
REGENTS UNIV OF CALIF LOS ANGELES
Active
Other names
Ronald Reagan UCLA - Medical Plaza Level I Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY WALLACE (CFO UCLA HOSPITAL SYSTEM)
(310) 794-8627
Entity
Organization
Contact information
Practice address
200 UCLA MEDICAL PLZ, SUITE 135, LOS ANGELES, CA 90095-6949
(310) 794-1176
(310) 794-1187
Mailing address
PHARMACY BUSINESS OFC, 757 WESTWOOD PLAZA, ROOM B504E, LOS ANGELES, CA 90095-7423
(310) 267-8517
(310) 267-3644
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHE40977
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275633224
—
CA
01
—
1992432
PK
—
05
—
PH0000235
—
CA
Enumeration date
09/22/2006
Last updated
07/22/2022
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