NPIMap

Organization Active NPI

Regents of the University of California

  • Multi-Specialty Clinic/Center
  • Elk Grove, CA
National Provider Identifier
1174966071
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Practice address
9390 Big Horn Blvd
Elk Grove, CA 95758-7978
Phone
(916) 683-3950
NPI assigned
Apr 10, 2013
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Allen D HallNPI 1760466924
Title
Medical Director
Phone
(916) 734-8203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

9390 Big Horn Blvd
Elk Grove, CA 95758-7978

Mailing address

10850 White Rock Rd
Rancho Cordova, CA 95670-6044
Phone (916) 734-9255

Other names 1

  • Regents UCDMG Elk Grove Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118001149 CA Part B Supplier - Clinic/Group Practice 8022922475 Receives reassigned benefits from 924 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; Stockton, CA; Walnut Creek, CA; Roseville, CA; Auburn, CA; Chico, CA; Citrus Heights, CA; Davis, CA…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Regents of the University of California14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1174966071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 WHITE ROCK RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706044",
            "telephone_number": "916-734-9255",
            "fax_number": "916-736-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9390 BIG HORN BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587978",
            "telephone_number": "916-683-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2023-10-09",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-734-8203"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents UCDMG Elk Grove",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Regents UCDMG Elk Grove",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.