Basic Information
Provider Information
NPI: 1235107566
EntityType: 2
ReplacementNPI:  
OrganizationName: THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UCLA DEPT OF MEDICINE PROFESSNL GR
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 24DD5
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900740001
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber: 3103018751
Practice Location
Address1: 200 MEDICAL PLAZA
Address2: SUITE 365,530,420,250,120,214
City: LOS ANGELES
State: CA
PostalCode: 900950001
CountryCode: US
TelephoneNumber: 3107941276
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/11/2006
LastUpdateDate: 12/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: OYE
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName: K
AuthorizedOfficialTitleorPosition: VICE CHAIR OF CLINICAL SERVICES
AuthorizedOfficialTelephone: 3102060644
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RG0300X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
207RH0003X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RI0001X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineClinical & Laboratory Immunology
207RI0008X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
207RI0200X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
207RN0300X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
207RR0500X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
207RE0101X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207RG0100X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207Q00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 
207RA0201X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
207RC0000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0200X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207R00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
GR005503K05CA MEDICAID
GR005503P05CA MEDICAID
GR005503V05CA MEDICAID
GR005503D05CA MEDICAID
GR005503605CA MEDICAID
GR005503505CA MEDICAID
GR005503905CA MEDICAID
GR005503J05CA MEDICAID
GR005503T05CA MEDICAID
GR005503005CA MEDICAID
GR005503805CA MEDICAID
GR005503E05CA MEDICAID
GR005503H05CA MEDICAID
GR005503M05CA MEDICAID
GR005503W05CA MEDICAID
GR005503A05CA MEDICAID
GR005503L05CA MEDICAID
GR005503105CA MEDICAID
GR005503705CA MEDICAID
GR005503F05CA MEDICAID


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