NPIMap

Organization Active NPI

Regents of the Univ of California

  • Community/Retail Pharmacy
  • Santa Monica, CA
National Provider Identifier
1396010609
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
50897 Issued in CA
Legal business name
REGENTS OF THE UNIV OF CALIFORNIA
Practice address
1223 16TH St RM 1202
Santa Monica, CA 90404-1217
Phone
(424) 259-8520
Fax
(424) 259-8524
NPI assigned
Mar 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Authorized official

Name
Diane Zalba
Title
Director, Pharmaceutical Serv
Phone
(310) 267-8500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 50897 CA Primary

Addresses

Primary practice location

1223 16TH St RM 1202
Santa Monica, CA 90404-1217

Mailing address

1223 16TH St RM 1202
Santa Monica, CA 90404-1217
Phone (424) 259-8520

Other identifiers 2

IdentifierTypeStateIssuer
2134261OtherPK
1396010609MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220721000263 CA DME Supplier - Pharmacy 6305880592 Practice locations: Santa Monica, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Santa Monica UCLA - Op Pharmacy1223 16TH St, Santa Monica, CA 90404-1217(424) 259-8520 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignmentParticipating since Sep 19, 2012

National Provider Directory

National Provider Directory
Tax ID family
Regents of the Univ of California10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1223 16th St
Ste 2100
Santa Monica, CA 90404
Phone (424) 259-8859

1223 16th St
Ste 1202
Santa Monica, CA 90404
Phone (424) 259-8520

1336 16th St
Santa Monica, CA 90404
Phone (310) 319-4338

1131 Wilshire Blvd
Ste 200
Santa Monica, CA 90401
Phone (310) 458-5121

1223 16th St
Rm 1202
Santa Monica, CA 90404
Phone (424) 259-8520

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Santa Monica Uclamc & OrthopaedicSanta Monica, CA, CCN 050112 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 21, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1396010609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 16TH ST RM 1202",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041217",
            "telephone_number": "424-259-8520",
            "fax_number": "424-259-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 16TH ST RM 1202",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041217",
            "telephone_number": "424-259-8520",
            "fax_number": "424-259-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIV OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "ZALBA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "DIRECTOR, PHARMACEUTICAL SERV",
        "authorized_official_telephone_number": "310-267-8500"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "50897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134261",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396010609",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.