Organization
REGENTS OF THE UNIV OF CALIFORNIA
Active
Other names
Ronald Reagan UCLA - Medical Plaza Level I Pharmacy, Santa Monica - Outpatient Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY LEHR WALLACE (CHIEF FINANCIAL OFFICER)
(310) 267-9307
Entity
Organization
Contact information
Practice address
1131 WILSHIRE BOULEVARD, SUITE 200, LOS ANGELES, CA 90404-1249
(424) 259-7140
Mailing address
757 WESTWOOD PLZ STE 1320, LOS ANGELES, CA 90095-7400
(310) 267-9308
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427055839
—
CA
Enumeration date
09/08/2017
Last updated
01/28/2026
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