NPIMap

Organization Active NPI

UC Irvine Health Specialty Clinic- Tustin

  • Medical Specialty Clinic/Center
  • Tustin, CA
National Provider Identifier
1871979435
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN
Practice address
1451 Irvine Blvd
Tustin, CA 92780-3804
Phone
(714) 838-8878
Fax
(714) 838-8988
NPI assigned
Aug 6, 2015
Organization subpart
Yes
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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 and Chief Executive
Phone
(714) 456-2986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1451 Irvine Blvd
Tustin, CA 92780-3804

Mailing address

PO Box 515072
Los Angeles, CA 90051-5072
Phone (714) 456-5717

National Provider Directory

National Provider Directory
Tax ID family
Aesthetic and Plastic Surgery Institute3 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.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1871979435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515072",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900515072",
            "telephone_number": "714-456-5717",
            "fax_number": "714-456-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803804",
            "telephone_number": "714-838-8878",
            "fax_number": "714-838-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "PORTO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF EXECUTIVE",
        "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": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.