Provider Demographics
NPI:1003472333
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Other - Org Name:UCLA ORTHOPEDIC SURGERY MED GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROFESSSOR AND CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORNICEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-794-7930
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 LOMITA BLVD
Practice Address - Street 2:SUITE M100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5003
Practice Address - Country:US
Practice Address - Phone:310-319-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty