Organization
REGENTS OF THE UNIV OF CA
Active
Other names
Regents/UCD PBG/ Genetics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES D KIRK MD (CMO)
(916) 734-1166
Entity
Organization
Contact information
Practice address
4860 Y ST, SACRAMENTO, CA 95817-2307
(916) 734-6930
(916) 734-6666
Mailing address
4900 BROADWAY, SUITE 2600, SACRAMENTO, CA 95820-1532
(916) 734-9200
(916) 734-9661
Taxonomy
Speciality
Code
Description
License number
State
261QG0250X
Genetics Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GNP000070
—
CA
05
—
GRW02104K
—
CA
Enumeration date
10/13/2005
Last updated
03/21/2014
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