NPIMap

Organization Active NPI

Minuteclinic Diagnostic Medical Group of Orange County Inc

  • Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1104013879
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF ORANGE COUNTY INC
Practice address
14330 Culver Dr
Irvine, CA 92604-0303
Phone
(866) 389-2727
Fax
(401) 406-3539
NPI assigned
Sep 26, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Corporate family (same tax ID) 2

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

Practitioners 231

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 231

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090116000214 CA Part B Supplier - Clinic/Group Practice 5991868929 Receives reassigned benefits from 205 practitioners
Practice locations: Irvine, CA; Yorba Linda, CA; Temecula, CA; Seal Beach, CA; San Clemente, CA; Riverside, CA; Rancho Cucamonga, CA; Mission Viejo, CA…

National Provider Directory

Tax ID family
Minuteclinic Diagnostic Medical Group of Orange County Inc (3 organizations share this tax ID)

Locations

1660 W Katella Ave
Anaheim, CA 92802
Phone (714) 530-0900

30842 Coast Hwy
Ste 1
Laguna Beach, CA 92651

21761 Lake Forest Dr
Lake Forest, CA 92630
Phone (949) 855-0144

4040 E Chapman Ave
Orange, CA 92869
Phone (714) 539-8729

1535 E Katella Ave
Orange, CA 92867
Phone (714) 639-6060

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

491 E Alessandro Blvd
Riverside, CA 92508
Phone (951) 780-1835

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154

18080 Imperial Hwy
Yorba Linda, CA 92886
Phone (714) 504-4665

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

14330 Culver Dr
Irvine, CA 92604-0303

Mailing address

PO Box 772
Minuteclinic Credentialing
Woonsocket, RI 02895-0784
Phone (866) 389-2727

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 11, 2024.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1104013879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "MINUTECLINIC CREDENTIALING",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14330 CULVER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040303",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF ORANGE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 11, 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.