Organization
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Other names
UCLA DEPT OF DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
KATHIE HALE (DIRECTOR)
(310) 301-5311
Entity
Organization
Contact information
Practice address
200 MEDICAL PLZ, SUITE 450,465, LOS ANGELES, CA 90095-0001
(310) 206-8694
(310) 794-7005
Mailing address
5767 W CENTURY BLVD SUITE 400, LOS ANGELES, CA 90074-5737
(310) 301-5200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0055110
—
CA
05
—
GR0055111
—
CA
Enumeration date
03/15/2006
Last updated
04/10/2025
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