# TUSTIN HOSPITAL AND MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TUSTIN HOSPITAL AND MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578684395
- **Authorized official:** FAREED ENTEZAR PHARMD (PHARMACY DIRECTOR)
- **Authorized official phone:** (714) 669-5874

## Contact information

- **Practice address:** 14662 NEWPORT AVE, TUSTIN, CA 92780-6064
- **Practice address phone:** (714) 669-5874
- **Practice address fax:** (714) 669-2011
- **Mailing address:** 14662 NEWPORT AVE, TUSTIN, CA 92780-6064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | HSP43375 | CA | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 02/18/2009