NPIMap

Organization Active NPI

Regents Univ of Calif Los Angeles

Doing business as Ronald Reagan UCLA - Medical Plaza Level I Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Los Angeles, CA
National Provider Identifier
1831497270
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
930000165 Issued in CA
Legal business name
REGENTS UNIV OF CALIF LOS ANGELES
Doing business as
Ronald Reagan UCLA - Medical Plaza Level I Pharmacy
Ronald Reagan UCLAMC
Practice address
1000 Veteran Ave
A -744
Los Angeles, CA 90024-2704
Phone
(310) 794-1323
Fax
(310) 794-1457
NPI assigned
Mar 9, 2011
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Mrs. Tammy Lehr Wallace
Title
Chief Financial Officer
Phone
(310) 267-9307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 930000165 CA Primary

Addresses

Primary practice location

1000 Veteran Ave
A -744
Los Angeles, CA 90024-2704

Mailing address

757 Westwood PLZ
Los Angeles, CA 90095-1730
Phone (310) 267-9308

Other names 2

  • Ronald Reagan UCLA - Medical Plaza Level I Pharmacy Doing business as
  • Ronald Reagan UCLAMC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111219000743 CA DME Supplier - Hospital 6901856186 Practice locations: Los Angeles, CA

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Michael C Graves MD56 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

1000 Veteran Ave
Los Angeles, CA 90095

1000 Veteran Ave
#744
Los Angeles, CA 90024
Phone (310) 794-1323

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
California Rehabilitation InstituteLos Angeles, CA, CCN 053039 Hospital 5% Or Greater Direct Ownership Interest (10.9%) Dec 1, 2015
UCLA West Valley Medical CenterWest Hills, CA, CCN 050481 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 29, 2024
Accentcare UCLA Health LLCWest Hills, CA, CCN 057761 Home health agency 5% Or Greater Indirect Ownership Interest (30%) May 31, 2019

Owned or controlled facilities with NPI records 3

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

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1831497270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951730",
            "telephone_number": "310-267-9308",
            "fax_number": "310-267-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VETERAN AVE",
            "address_2": "A -744",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242704",
            "telephone_number": "310-794-1323",
            "fax_number": "310-794-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS UNIV OF CALIF LOS ANGELES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LEHR",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "310-267-9307",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "930000165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ronald Reagan UCLA - Medical Plaza Level I Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ronald Reagan UCLAMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ronald Reagan UCLAMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.