Provider Demographics
NPI:1275643694
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Other - Org Name:MANCHESTER SURGICAL PAVILION-UCI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES-SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-456-3228
Mailing Address - Street 1:200 S MANCHESTER AVE STE 650
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3224
Mailing Address - Country:US
Mailing Address - Phone:714-456-3077
Mailing Address - Fax:714-456-2229
Practice Address - Street 1:200 S MANCHESTER AVE STE 650
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3224
Practice Address - Country:US
Practice Address - Phone:714-456-3077
Practice Address - Fax:714-456-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical