Organization
REGENTS OF THE UNIVERSITY OF CALIF
Active
Other names
Academic OB/GYN Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL PORTO MD (DEPT CHAIRMAN)
(714) 456-6431
Entity
Organization
Contact information
Practice address
101 CITY DRIVE SOUTH, BLDG 56 SUITE 800, ORANGE, CA 92868
(714) 456-6431
(714) 456-7754
Mailing address
PO BOX 54538, LOS ANGELES, CA 90054-0538
(714) 456-6431
(714) 456-7754
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
—
—
207VE0102X
Reproductive Endocrinology Physician
—
—
207VG0400X
Gynecology Physician
Primary
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207VX0000X
Obstetrics Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0041410
MEDI-CAL
CA
Enumeration date
04/11/2006
Last updated
09/11/2025
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