NPIMap

Organization Active NPI

Regents of the University of Ca.

  • Primary Podiatric Medicine Podiatrist
  • Elk Grove, CA
National Provider Identifier
1255529236
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
E4735 Issued in CA
Legal business name
REGENTS OF THE UNIVERSITY OF CA.
Practice address
8110 Laguna Blvd
Elk Grove, CA 95758-7904
Phone
(916) 683-3955
Fax
(916) 736-1419
NPI assigned
Oct 4, 2007
Last updated
Feb 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Allen D Hall, M.D.NPI 1760466924
Title
Cfo
Phone
(916) 734-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X E4735 CA Primary

Addresses

Primary practice location

8110 Laguna Blvd
Elk Grove, CA 95758-7904

Mailing address

4900 Broadway Ste 1200
Sacramento, CA 95820-1535
Phone (916) 734-9255

Other names 1

  • UC Davis Medical Group Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0915224UC Davis Medical Group8110 Laguna Blvd, Elk Grove, CA 95758Provider-performed microscopyOct 12, 2027

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 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1255529236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROADWAY STE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201535",
            "telephone_number": "916-734-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 LAGUNA BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587904",
            "telephone_number": "916-683-3955",
            "fax_number": "916-736-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "916-734-9200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UC Davis Medical Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "UC Davis Medical Group",
            "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 Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.