NPIMap

Organization Active NPI

Portola Medical Services PC

  • Urgent Care Clinic/Center
  • Lake Forest, CA
National Provider Identifier
1871962076
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PORTOLA MEDICAL SERVICES PC
Practice address
29100 Portola Pkwy
Suite B
Lake Forest, CA 92630-8712
Phone
(844) 254-6382
Fax
(331) 442-4902
NPI assigned
Sep 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Dr. Matthew A Zeller, DONPI 1700970332
Title
Ceo
Phone
(949) 813-9728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

29100 Portola Pkwy
Suite B
Lake Forest, CA 92630-8712

Mailing address

29100 Portola Pkwy
Suite B
Lake Forest, CA 92630-8712
Phone (844) 254-6382

Other names 2

  • Clineva Urgent Care Doing business as
  • Clineva Urgent Care Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160830002440 CA Part B Supplier - Clinic/Group Practice 4789970773 Receives reassigned benefits from 29 practitioners
Practice locations: Lake Forest, CA; Yorba Linda, CA; Orange, CA; Laguna Niguel, CA; Fountain Valley, CA; Cypress, CA
O20180108001682 CA DME Supplier - Physician - Family Practice 4789970773 Practice locations: Lake Forest, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2325413Portola Medical Services PC29100 Portola Pkwy, Ste B, Lake Forest, CA 92630Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Locations

6876 Katella Ave
Cypress, CA 90630
Phone (714) 903-8900

9025 Warner Ave
Ste B
Fountain Valley, CA 92708
Phone (844) 254-6382

9025 Warner Ave
Ste C
Fountain Vly, CA 92708

25461 Rancho Niguel Rd
Laguna Niguel, CA 92677
Phone (844) 254-6382

29100 Portola Pkwy
Ste B
Lake Forest, CA 92630
Phone (844) 254-6382

1511 E Katella Ave
Orange, CA 92867
Phone (844) 254-6382

20635 Yorba Linda Blvd
Yorba Linda, CA 92886
Phone (714) 581-9497

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1871962076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29100 PORTOLA PKWY",
            "address_2": "SUITE B",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308712",
            "telephone_number": "844-254-6382",
            "fax_number": "949-535-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29100 PORTOLA PKWY",
            "address_2": "SUITE B",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308712",
            "telephone_number": "844-254-6382",
            "fax_number": "331-442-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTOLA MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "ZELLER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-813-9728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clineva Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clineva Urgent Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.