Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCLA Orthopedic Surgery Med Group
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE HALE (DIRECTOR OF FINANCE)
(310) 301-5311
Entity
Organization
Contact information
Practice address
100 MEDICAL PLAZA SUITE 755, LOS ANGELES, CA 90095-0001
(424) 206-2386
Mailing address
5767 W CENTURY BLVD, STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
225100000X
Physical Therapist
—
CA
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0065850
—
CA
Enumeration date
08/31/2006
Last updated
06/11/2021
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