The Regents of the University of California

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

Legal business name

THE REGENTS OF THE UNIVERSITY OF CALIFORNIA

Doing business as

UCLA Pediatric Surgery Associates

Practice address

200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-8344

Phone

(310) 206-2429

NPI assigned

Apr 26, 2006

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• UCLA PEDIATRIC SURGERY ASSOCIATES Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 11

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

• Christian Stuart McEvoy, MD, MPH

  • Pediatric Surgery Physician
  • Los Angeles, CA
  • NPI 1083004949
  Medicare reassignment Care Compare group NPD
• Veronica Sullins, MD

  • Pediatric Surgery Physician
  • Los Angeles, CA
  • NPI 1982836060
  Medicare reassignment Care Compare group NPD
• Daniel Alberto Deugarte, MD

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1497971790

  Pediatric Surgery

  Medicare reassignment NPD
• Christine Elizabeth Dichter, RN, MSN, CPNP

  • Pediatric Nurse Practitioner
  • Los Angeles, CA
  • NPI 1255672218
  Medicare reassignment NPD
• Howard C. Jen, M.D.

  • Pediatric Surgery Physician
  • Los Angeles, CA
  • NPI 1841428323
  Medicare reassignment NPD
• Shant Shekherdimian, MD

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1063610251
  Medicare reassignment NPD
• Justin Philip Wagner, M.D.

  • Pediatric Surgery Physician
  • Los Angeles, CA
  • NPI 1871818484
  Medicare reassignment NPD
• Ronald W Busuttil, MD

  • Transplant Surgery Physician
  • Los Angeles, CA
  • NPI 1639103906
  NPD (past)
• Tamir H Keshen, MD

  • Pediatric Surgery Physician
  • Santa Barbara, CA
  • NPI 1831115054
  NPD (past)
• William N Kincannon, M.D.

  • Specialist
  • Santa Barbara, CA
  • NPI 1255373874
  NPD (past)
• Charles Jacob Stolar, M.D.

  • Pediatric Surgery Physician
  • Santa Barbara, CA
  • NPI 1437242252
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1851357941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-206-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "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": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCLA PEDIATRIC SURGERY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Regents of the University of California (UCLA Dental Oral Surgery Associates)
• The Regents of the University of California (Dental Practice UCLA Faculty Group)
• The Regents of the University of California (UCLA Rad-Onc Group Practice)
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California (UCLA Surgical Oncology Associates)
• The Regents of the University of California (UCLA Liver/Pancreas Transplant Associates)
• The Regents of the University of California (UCLA Cardiothoracic Surgery Associates)
• The Regents of the University of California (UCLA Neurology Group Practice)
• The Regents of the University of California (House Children's Hearing Center of UCLA)

• Pediatric Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.