Pacific CDDC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PACIFIC CDDC

Practice address

1640 Newport Blvd
Suite 350
Costa Mesa, CA 92627-3786

Phone

(949) 386-5260

Fax

(949) 515-0031

NPI assigned

Dec 13, 2016

Organization subpart

Yes

Parent organization

REGENT 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, M.D.

Title

President

Phone

(714) 456-2986

Specialties & licenses 1

Addresses

Part of

Regents of the University of California

Locations

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1861936601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54708",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900540708",
            "telephone_number": "714-456-3856",
            "fax_number": "714-456-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD",
            "address_2": "SUITE 350",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273786",
            "telephone_number": "949-386-5260",
            "fax_number": "949-515-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CDDC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENT OF THE UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "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": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Breast Care Center
• Pacific Breast Care Center
• Pacific Breast Care Medical Group, Inc.
• Pacific Cardiovascular Associates Medical Group, Inc.
• Pacific CDDC
• Pacific CDDC
• Pacific Coast Craniofacial and Pediatric Plastic Surgery Inc.
• Pacific Coast Mental Health LLC
• Pacific Coast Optometry, Inc.
• Pacific Medical Center

• All providers in Costa Mesa, CA
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.