Organization
UCI DEPARTMENT OF DERMATOLOGY
Active
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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