Provider Demographics
NPI:1114180635
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Other - Org Name:UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER CAARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.H.P. ASSISTANT CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-734-6637
Mailing Address - Street 1:3671 BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-2165
Mailing Address - Country:US
Mailing Address - Phone:916-734-6637
Mailing Address - Fax:916-734-4150
Practice Address - Street 1:3671 BUSINESS DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2165
Practice Address - Country:US
Practice Address - Phone:916-734-6637
Practice Address - Fax:916-734-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACR0028OtherRAILROAD MEDICARE PIN
CACN4844OtherRAILROAD MEDICARE PIN
CAGR002104MMedicaid
CADE7275OtherRAILROAD MEDICARE PIN
CAGNP000070Medicaid
CACI4127OtherRAILROAD MEDICARE PIN
CADA4168OtherRAILROAD MEDICARE PIN
CACN4400OtherRAILROAD MEDICARE PIN
CAGPS000040Medicaid
CAZZZP5701ZOtherMEDICAID/CHDP PIN
CAZZZP5701ZOtherMEDICAID/CHDP PIN