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Organization
PACIFIC BREAST CARE CENTER
Active
Organization
PACIFIC BREAST CARE CENTER
Active
Parent organization
UNIVERSITY OF CALIFORNIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF CALIFORNIA
Authorized official
DR. JOHN A HEYDT M.D. (CHIEF EXECUTIVE OFFICER)
(714) 456-2986
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD STE 200, COSTA MESA, CA 92627-3786
(949) 515-3544
(949) 515-3644
Mailing address
1640 NEWPORT BLVD STE 200, COSTA MESA, CA 92627-3786
(949) 515-3544
(949) 515-3644
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
060000148
CA
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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