NPIMap

Organization Active NPI

Omid Vesal, MD, Medical Corporation

  • Internal Medicine Physician
  • Irvine, CA
National Provider Identifier
1912947110
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A73459 Issued in CA
Legal business name
OMID VESAL, MD, MEDICAL CORPORATION
Practice address
2500 Alton Pkwy
Suite 101
Irvine, CA 92606-5032
Phone
(949) 222-2722
Fax
(949) 222-9969
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Authorized official

Name
Dr. Omid Vesal, M.D.NPI 1003856204
Title
President
Phone
(949) 222-2722

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A73459 CA Primary

Addresses

Primary practice location

2500 Alton Pkwy
Suite 101
Irvine, CA 92606-5032

Mailing address

2500 Alton Pkwy
Suite 101
Irvine, CA 92606-5032
Phone (949) 222-2722

Other identifiers 3

IdentifierTypeStateIssuer
00A734590MedicaidCA
C2814009OtherCACALIFORNIA CORPORATION NO
ZZZ13101ZOtherCABLUE SHIELD PIN

Other names 1

  • Irvine Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060419000365 CA Part B Supplier - Clinic/Group Practice 3779592712 Receives reassigned benefits from 3 practitioners
Practice locations: Irvine, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1912947110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ALTON PKWY",
            "address_2": "SUITE 101",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065032",
            "telephone_number": "949-222-2722",
            "fax_number": "949-222-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALTON PKWY",
            "address_2": "SUITE 101",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065032",
            "telephone_number": "949-222-2722",
            "fax_number": "949-222-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMID VESAL, MD, MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "VESAL",
        "authorized_official_first_name": "OMID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-222-2722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A734590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CORPORATION NO",
            "identifier": "C2814009",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ13101Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Irvine Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.