Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCLA IPN SCOI
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE HALE (FINANCIAL OFFICER)
(310) 301-5311
Entity
Organization
Contact information
Practice address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 616-8023
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0105X
Surgery of the Hand (Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
10/22/2018
Last updated
01/10/2019
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