Provider Demographics
NPI:1174626618
Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF CALIFORNIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE CYCLE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGO
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:918-809-2411
Mailing Address - Street 1:FILE 57326
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:800-926-8273
Practice Address - Fax:888-539-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2327OtherCMS
364823304OtherUS DEPT OF LABOR
364823307OtherUS DEPT OF LABOR
364823310OtherUS DEPT OF LABOR
CAZZZP3721ZOtherCALOPTIMA
CAZZZP3721ZMedicaid
CACNMW00130Medicaid
CAZZZP3721ZOtherBLUE SHIELD OF CALIFORNIA
CQ4024OtherRAILROAD MEDICARE
364823302OtherUS DEPT OF LABOR
364823305OtherUS DEPT OF LABOR
364823306OtherUS DEPT OF LABOR
CA364823301OtherUS DEPT OF LABOR
CACGP016905OtherGHPP
364823308OtherUS DEPT OF LABOR
364823300OtherUS DEPT OF LABOR
364823303OtherUS DEPT OF LABOR
364823306OtherUS DEPT OF LABOR
CACNMW00130Medicaid