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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