Organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A HEYDT MD (CEO/PRESIDEN)
(714) 456-8068
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8068
Mailing address
PO BOX 54509, LOS ANGELES, CA 90054-0509
(714) 456-8068
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPS001170
—
CA
Enumeration date
06/08/2011
Last updated
06/08/2011
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