NPIMap

Organization Active NPI

Pacific Breast Care Center

  • Medical Specialty Clinic/Center
  • Costa Mesa, CA
National Provider Identifier
1144564469
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
060000148 Issued in CA
Legal business name
PACIFIC BREAST CARE CENTER
Practice address
1640 Newport Blvd Ste 200
Costa Mesa, CA 92627-3786
Phone
(949) 515-3544
Fax
(949) 515-3644
NPI assigned
Nov 27, 2012
Organization subpart
Yes
Parent organization
UNIVERSITY OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Dr. John A Heydt, M.D.
Title
Chief Executive Officer
Phone
(714) 456-2986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 060000148 CA Primary

Addresses

Primary practice location

1640 Newport Blvd Ste 200
Costa Mesa, CA 92627-3786

Mailing address

1640 Newport Blvd Ste 200
Costa Mesa, CA 92627-3786
Phone (949) 515-3544

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

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1144564469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273786",
            "telephone_number": "949-515-3544",
            "fax_number": "949-515-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273786",
            "telephone_number": "949-515-3544",
            "fax_number": "949-515-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC BREAST CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "HEYDT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-456-2986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "060000148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.