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Organization
ORTHOPEDIC AND SPORTS MEDICINE CENTER
Active
Organization
ORTHOPEDIC AND SPORTS MEDICINE CENTER
Active
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Authorized official
DR. MANUEL PORTO M.D. (INTERIM PRESIDENT)
(714) 456-2986
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD, SUITE 230, COSTA MESA, CA 92627-3786
(949) 515-5210
(855) 519-4485
Mailing address
PO BOX 513228, LOS ANGELES, CA 90051-3228
(714) 456-3908
(714) 456-2338
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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