Provider Demographics
NPI:1588891865
Name:REGENTS OF UC
Entity type:Organization
Organization Name:REGENTS OF UC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ELAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-413-2257
Mailing Address - Street 1:1250 LA VENTA DRIVE SUITE 112
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:805-496-5153
Mailing Address - Fax:805-496-5202
Practice Address - Street 1:1250 LA VENTA DRIVE SUITE 112
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-496-5153
Practice Address - Fax:805-496-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty