# GOTTSCHALK MEDICAL PLAZA - DERMATOLOGY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** REGENTS OF THE UNIVERSITY OF CALIFORNIA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598201253
- **Legal business name:** REGENTS OF THE UNIVERSITY OF CALIFORNIA
- **Authorized official:** DR. MANUEL PORTO MD (PRESIDENT & CEO)
- **Authorized official phone:** (714) 456-2986

## Contact information

- **Practice address:** 1 MEDICAL PLAZA DR, BLDG. 820, IRVINE, CA 92697-3950
- **Practice address phone:** (949) 824-0606
- **Practice address fax:** (855) 209-8413
- **Mailing address:** PO BOX 513230, LOS ANGELES, CA 90051-3230
- **Mailing address phone:** (714) 456-3760
- **Mailing address fax:** (714) 456-2398

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2017
- **Last updated:** 01/18/2017