Individual provider Active NPI

Antoine A Mourra, MD

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1447278296
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A34465 Issued in CA
Practice address
14150 Culver Dr Ste 100
Irvine, CA 92604-0322
Phone
(949) 552-4584
Fax
(949) 551-5612
NPI assigned
Jul 18, 2006
Last updated
Dec 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A34465 CA Primary

Addresses

Primary practice location

14150 Culver Dr Ste 100
Irvine, CA 92604-0322

Mailing address

14150 Culver Dr
#100
Irvine, CA 92604-0315
Phone (949) 552-4584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000535 CA Practitioner - Family Practice 1759416795 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of California IrvineGroup PAC ID 5395658181, 57 clinicians

Practice addresses (Care Compare)

800 N Main St
Santa Ana, CA 92701-3576
Phone (714) 456-6324

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Regents of the University of Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
UC Irvine Health Cancer Center, Newport Pacific Medical Center CurrentSince Sep 1, 2023 Accepting new patients
University of California Irvine Current Accepting new patients
University of California Irvine CurrentSince Sep 1, 2023 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

14150 Culver Dr
Ste 100
Irvine, CA 92604
Phone (949) 552-4584

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Organizations & group practices 8

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1447278296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR",
            "address_2": "#100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040315",
            "telephone_number": "949-552-4584",
            "fax_number": "949-551-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040322",
            "telephone_number": "949-552-4584",
            "fax_number": "949-551-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURRA",
        "first_name": "ANTOINE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A34465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.