Organization
REGENTS OF THE UNIV OF CA
Active
Other names
Regents UCD PBG PED RHEUM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES D KIRK MD (CMO)
(916) 734-1166
Entity
Organization
Contact information
Practice address
2521 STOCKTON BLVD, SACRAMENTO, CA 95817-2207
(916) 734-3179
(916) 456-2236
Mailing address
4900 BROADWAY, STE 2600, SACRAMENTO, CA 95820-1532
(916) 734-9200
(916) 734-9661
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI4127
RAILROAD MEDICARE PIN
CA
01
—
CN4400
RAILROAD MEDICARE PIN
CA
01
—
CN4844
RAILROAD MEDICARE PIN
CA
01
—
CR0028
RAILROAD MEDICARE PIN
CA
01
—
DA4168
RAILROAD MEDICARE PIN
CA
01
—
DE7275
RAILROAD MEDICARE PIN
CA
05
—
GNP000070
—
CA
05
—
GRW021043
—
CA
01
—
ZZZP5701Z
MEDICAID/CHDP PIN
CA
Enumeration date
08/24/2005
Last updated
03/21/2014
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