Provider Demographics
NPI:1346554474
Name:REGENTS OF THE UNIV OF CA
Entity Type:Organization
Organization Name:REGENTS OF THE UNIV OF CA
Other - Org Name:UCD PROFESSIONAL BILLING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIEFKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-734-1166
Mailing Address - Street 1:4900 BROADWAY
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1532
Mailing Address - Country:US
Mailing Address - Phone:916-734-9663
Mailing Address - Fax:916-734-9661
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-9663
Practice Address - Fax:916-734-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000086207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty