Individual provider Active NPI

Carol Quilligan Gardner, M.D.

  • Pediatric Adolescent Medicine Physician
  • Irvine, CA
National Provider Identifier
1386866176
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
G72702 Issued in CA
Practice address
2646 Dupont Dr
Suite 250
Irvine, CA 92612-8887
Phone
(949) 261-2981
Fax
(949) 261-8292
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X G72702 CA Primary
Community Health Clinic/Center 261QC1500X CA

Addresses

Primary practice location

2646 Dupont Dr
Suite 250
Irvine, CA 92612-8887

Mailing address

6 Harvey CT
Irvine, CA 92617-4033
Phone (949) 854-2803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G72702CAMDPediatric Adolescent Medicine Physician
550000003CAMDCommunity Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Birth Choice Community Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1386866176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HARVEY CT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926174033",
            "telephone_number": "949-854-2803",
            "fax_number": "949-856-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 DUPONT DR",
            "address_2": "SUITE 250",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128887",
            "telephone_number": "949-261-2981",
            "fax_number": "949-261-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CAROL",
        "middle_name": "QUILLIGAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "G72702",
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 11, 2025; 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.