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Organization

REGENTS OF UNIVERSITY OF CALIFORNIA

Active
Other names
UCLA Dental Radiology Practice
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANJAY MALLYA DDS (PROFESSOR)
(310) 825-1689
Entity
Organization

Contact information

Practice address
10833 LE CONTE AVE, CHS 10 -165, LOS ANGELES, CA 90095-1668
(310) 825-5634
(310) 206-2748
Mailing address
10833 LE CONTE AVE., CHS 53-068, LOS ANGELES, CA 90095-1668
(310) 825-1689
(310) 825-7232

Taxonomy

Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
CA

Other

Enumeration date
02/23/2007
Last updated
10/02/2025
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