Provider Demographics
NPI:1346554631
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 - TRANSPLANT
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-734-4055
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:916-734-9200
Mailing Address - Fax:916-734-9661
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:ROOM 1018
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000086282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059808Medicare PIN