NPIMap

Organization Active NPI

UC Irvine Health CDDC High Desert

  • Multi-Specialty Clinic/Center
  • Victorville, CA
National Provider Identifier
1720536550
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
UC IRVINE HEALTH CDDC HIGH DESERT
Practice address
12595 Hesperia Rd
Suite 101
Victorville, CA 92395-5882
Phone
(760) 269-3099
Fax
(760) 269-3038
NPI assigned
Sep 21, 2016
Organization subpart
Yes
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

12595 Hesperia Rd
Suite 101
Victorville, CA 92395-5882

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
Regents of the University of California

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": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1720536550",
    "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": "12595 HESPERIA RD",
            "address_2": "SUITE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955882",
            "telephone_number": "760-269-3099",
            "fax_number": "760-269-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC IRVINE HEALTH CDDC HIGH DESERT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.