Organization
PACIFIC BREAST CARE CENTER
Active
Parent organization
REGENTS OF UNIVERSITY OF CALIFORNIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENTS OF UNIVERSITY OF CALIFORNIA
Authorized official
DR. MANUEL PORTO MD (INTERIM PRESIDENT)
(714) 456-2986
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD, SUITE 200, COSTA MESA, CA 92627-3786
(949) 515-3544
(949) 456-6216
Mailing address
PO BOX 513255, LOS ANGELES, CA 90051-3255
(714) 456-3851
(714) 456-6216
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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