Provider Demographics
NPI:1811255060
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PHYSICIAN RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERENCIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-827-7793
Mailing Address - Street 1:PO BOX 741696
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-1696
Mailing Address - Country:US
Mailing Address - Phone:866-819-6298
Mailing Address - Fax:
Practice Address - Street 1:3390 UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3315
Practice Address - Country:US
Practice Address - Phone:844-827-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty