NPIMap

Organization Active NPI

Regents of the University of California Los Angeles

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1609194497
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES
Practice address
11303 W Washington Blvd
Suite 100
Los Angeles, CA 90066-6003
Phone
(310) 391-7281
NPI assigned
May 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Katherine Hale
Title
Finance Director
Phone
(310) 301-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

11303 W Washington Blvd
Suite 100
Los Angeles, CA 90066-6003

Mailing address

File 2939
Los Angeles, CA 90074-2939
Phone (310) 206-3500

Other identifiers 1

IdentifierTypeStateIssuer
1609194497MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020001402 CA Part B Supplier - Clinic/Group Practice 4587857727 Receives reassigned benefits from 103 practitioners

National Provider Directory

National Provider Directory

Locations

24302 Paseo de Valencia
Ste 201
Laguna Hills, CA 92653
Phone (949) 598-1701

300 UCLA Medical Plz
Ste 3200A
Los Angeles, CA 90095

Practitioners & affiliated clinicians

Practitioners 107

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

View all 107

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1609194497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 2939",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742939",
            "telephone_number": "310-206-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11303 W WASHINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666003",
            "telephone_number": "310-391-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "310-301-5311"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609194497",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.