Provider Demographics
NPI:1265277792
Name:REGENTS OF THE UNIV OF CA
Entity type:Organization
Organization Name:REGENTS OF THE UNIV OF CA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, GOVERNMENT REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TROVATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-734-9112
Mailing Address - Street 1:10850 WHITE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6044
Mailing Address - Country:US
Mailing Address - Phone:916-734-9200
Mailing Address - Fax:916-703-5781
Practice Address - Street 1:2700 STOCKTON BLVD RM 1306
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2217
Practice Address - Country:US
Practice Address - Phone:916-734-3337
Practice Address - Fax:916-703-5781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory