Organization Active NPI

Regents of the University of California

Doing business as UCLA Pharm & Nm Practice Group

  • In Vivo & In Vitro Nuclear Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1851463723
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Vivo & In Vitro Nuclear Medicine PhysicianTaxonomy code 207UN0903X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Doing business as
UCLA Pharm & Nm Practice Group
Practice address
200 Medical PLZ
Suite B114
Los Angeles, CA 90095-8344
Phone
(310) 794-9513
Fax
(310) 267-2538
NPI assigned
Nov 15, 2006
Last updated
Jan 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Christine Wang
Title
Cao
Phone
(310) 267-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Vivo & In Vitro Nuclear Medicine Physician 207UN0903X NU Primary

Addresses

Primary practice location

200 Medical PLZ
Suite B114
Los Angeles, CA 90095-8344

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
GR0059610MedicaidCA

Other names 1

  • UCLA Pharm & Nm Practice Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041005000375 CA Part B Supplier - Clinic/Group Practice 5890754048 Receives reassigned benefits from 17 practitioners
Practice locations: Encino, CA; West Hills, CA; Thousand Oaks, CA; Santa Monica, CA; Santa Clarita, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

26585 Agoura Rd
Ste 210
Calabasas, CA 91302
Phone (818) 878-0028

10833 Le Conte Ave
Ste AR105
Los Angeles, CA 90095
Phone (310) 794-9513

200 UCLA Medical Plz
Ste B16
Los Angeles, CA 90095

2939 File Box
Los Angeles, CA 90074

757 Westwood Plz
Ste B114
Los Angeles, CA 90095

1187 Coast Village Rd
Ste 10A
Santa Barbara, CA 93108
Phone (805) 565-0020

1245 16th St
Ste 302
Santa Monica, CA 90404
Phone (310) 319-5022

1250 16th St
Ste 1401
Santa Monica, CA 90404

2020 Santa Monica Blvd
Ste 240
Santa Monica, CA 90404
Phone (310) 582-6220

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1851463723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLZ",
            "address_2": "SUITE B114",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-794-9513",
            "fax_number": "310-267-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "310-267-1188"
    },
    "taxonomies": [
        {
            "code": "207UN0903X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCLA Pharm & Nm Practice Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 8, 2021; 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.