Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UC Davis 48X Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DOLL (CHIEF FINANCIAL OFFICER)
(916) 734-9446
Entity
Organization
Contact information
Practice address
4868 X ST STE 1500, SACRAMENTO, CA 95817-2205
(916) 734-6250
Mailing address
PO BOX 744719, LOS ANGELES, CA 90074-4719
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
43732
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336487685
—
CA
01
—
5646320
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
PHE60029
CALIFORNIA STATE BOARD OF PHARMACY
CA
Enumeration date
01/22/2013
Last updated
12/11/2025
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