Organization Active NPI

Tustin Irvine Medical Group, PC

  • Urgent Care Clinic/Center
  • Valencia, CA
National Provider Identifier
1053576876
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
TUSTIN IRVINE MEDICAL GROUP, PC
Practice address
25124 Springfield CT
Suite 200
Valencia, CA 91355-1085
Phone
(661) 678-2600
Fax
(661) 678-2700
NPI assigned
Jul 21, 2008
Last updated
Feb 9, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
U.S. HEALTHWORKS MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Authorized official

Name
Mr. Joseph T Mallas
Title
Assistant Secretary
Phone
(661) 678-2626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0500X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

25124 Springfield CT
Suite 200
Valencia, CA 91355-1085

Mailing address

25124 Springfield CT
Suite 200
Valencia, CA 91355-1085
Phone (661) 678-2600

Other identifiers 1

IdentifierTypeStateIssuer
CU798AOtherMEDICARE GROUP PTAN

National Provider Directory

National Provider Directory
Part of
U S Healthworks

Locations

15751 Rockfield Blvd
Ste 200
Irvine, CA 92618

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1053576876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25124 SPRINGFIELD CT",
            "address_2": "SUITE 200",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551085",
            "telephone_number": "661-678-2600",
            "fax_number": "661-678-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25124 SPRINGFIELD CT",
            "address_2": "SUITE 200",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551085",
            "telephone_number": "661-678-2600",
            "fax_number": "661-678-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSTIN IRVINE MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. HEALTHWORKS MEDICAL GROUP, PC",
        "enumeration_date": "2008-07-21",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "MALLAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "661-678-2626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "CU798A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.