Provider Demographics
NPI:1821226952
Name:UNIVERSITY OF CALIFORNIA, IRVINE
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA, IRVINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHAIR, EDUCATIONAL AFFAIRS, ME
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-456-7539
Mailing Address - Street 1:101 THE CITY DR S
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:714-456-6693
Mailing Address - Fax:
Practice Address - Street 1:3802 PINE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3234
Practice Address - Country:US
Practice Address - Phone:858-232-0953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-26
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital