Gottschalk Medical Plaza - Dermatology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

GOTTSCHALK MEDICAL PLAZA - DERMATOLOGY

Practice address

1 Medical Plaza Dr
BLDG. 820
Irvine, CA 92697-3950

Phone

(949) 824-0606

Fax

(855) 209-8413

NPI assigned

Jan 18, 2017

Organization subpart

Yes

Parent organization

REGENTS OF THE UNIVERSITY OF CALIFORNIAAs reported in NPPES

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

Authorized official

Name

Dr. Manuel Porto, MD

Title

President & Ceo

Phone

(714) 456-2986

Specialties & licenses 1

Addresses

Tax ID family

Gottschalk Medical Plaza - Dermatology3 organizations share this tax ID, including this one

Part of

Regents of the University of California

Other organizations with this tax ID 2

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

• UC Irvine Health - Dept. of Dermatology

  • Medical Specialty Clinic/Center
  • Tustin, CA
  • NPI 1275909475
  NPD tax ID
• UC Irvine Health Dermatology Services

  • Medical Specialty Clinic/Center
  • Costa Mesa, CA
  • NPI 1942654439
  NPD tax ID

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1598201253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513230",
            "telephone_number": "714-456-3760",
            "fax_number": "714-456-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DR",
            "address_2": "BLDG. 820",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926973950",
            "telephone_number": "949-824-0606",
            "fax_number": "855-209-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTSCHALK MEDICAL PLAZA - DERMATOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "PORTO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "714-456-2986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Gorham
• Kaitlyn Gorjans
• Kassidy Gorman, MS
• Ferdinanda Margaretha Gortzak, IBCLC
• Fakirmohmed Mahmed Gosla, MD
• Valerie Gough
• Christina Goulart
• Gouvion and Grant Dentistry
• Wayne Anthony Gouvion, D.D.S.
• Krisstina Lorraine Gowin, D.O.

• Medical Specialty Clinic/Center in Irvine, CA
• Providers in Irvine, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.