NPIMap

Organization Active NPI

UC Irvine Health Specialty Clinic- Tustin (Surgery)

  • Clinic/Center
  • Tustin, CA
National Provider Identifier
1366897860
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN (SURGERY)
Practice address
1451 Irvine Blvd
Tustin, CA 92780-3804
Phone
(714) 838-8408
Fax
(877) 838-0003
NPI assigned
May 3, 2016
Last updated
May 3, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Dr. Manuel Porto, M.D.
Title
President
Phone
(714) 456-2986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1451 Irvine Blvd
Tustin, CA 92780-3804

Mailing address

PO Box 512347
Los Angeles, CA 90051-0347
Phone (714) 456-3856

National Provider Directory

National Provider Directory
Tax ID family
Mission Surgical Group8 organizations share this tax ID, including this one
Part of
Uci Student Health Center Pharmacy

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1366897860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512347",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510347",
            "telephone_number": "714-456-3856",
            "fax_number": "714-456-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803804",
            "telephone_number": "714-838-8408",
            "fax_number": "877-838-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN (SURGERY)",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "PORTO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-456-2986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.