NPIMap

Organization Active NPI

University of California Irvine

  • Community/Retail Pharmacy
  • Irvine, CA
National Provider Identifier
1093569105
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
UNIVERSITY OF CALIFORNIA IRVINE
Doing business as
UCI Health Irvine Outpatient Pharmacy ACC
Practice address
19208 Jamboree Road
BLDG 823, RM 2350
Irvine, CA 92612
Phone
(714) 456-5086
NPI assigned
Apr 15, 2024
Organization subpart
Yes
Parent organization
UNIVERSITY OF CALIFORNIA IRVINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Authorized official

Name
Gina Churchill
Title
Reimbursement Director
Phone
(714) 509-6266

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

19208 Jamboree Road
BLDG 823, RM 2350
Irvine, CA 92612

Mailing address

1500 S Douglass Rd
Suite 200, RT 183
Anaheim, CA 92806-6912
Phone (714) 509-6266

Other names 1

  • UCI Health Irvine Outpatient Pharmacy ACC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210420000679 CA Part B Supplier - Pharmacy 5395658181 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Irvine, CA; Orange, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Regents of the University of California42 organizations share this tax ID, including this one
Part of
Regents of the University of California

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

19208 Jamboree Rd
Bldg 823
Irvine, CA 92612
Phone (714) 456-5086

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1093569105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLASS RD",
            "address_2": "SUITE 200, RT 183",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928066912",
            "telephone_number": "714-509-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19208 JAMBOREE ROAD",
            "address_2": "BLDG 823, RM 2350",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92612",
            "telephone_number": "714-456-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA IRVINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF CALIFORNIA IRVINE",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "CHURCHILL",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "REIMBURSEMENT DIRECTOR",
        "authorized_official_telephone_number": "714-509-6266"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCI Health Irvine Outpatient Pharmacy ACC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.