Organization
UCI DEPARTMENT OF DERMATOLOGY
Active
Other names
UC REGENTS OF CALIFORNIA
Organization subpart
No
Provider details
NPI number
Authorized official
UCI HEALTH PROVIDER RELATIONS (UPS PROVIDER RELATIONS)
(714) 456-2986
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868
(714) 456-7004
Mailing address
PO BOX 31001-2462, PASADENA, CA 91110-2462
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0009660
—
CA
01
—
ZZZP3020Z
BLUE SHIELD ID NUMBER
CA
Enumeration date
05/08/2006
Last updated
08/16/2018
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