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Organization

UC IRVINE HEALTH MEDICAL GROUP- TUSTIN, FAM MED

Active
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Organization subpart
Yes

Provider details

NPI number
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Authorized official
DR. MANUEL PORTO M.D. (PRESIDENT)
(714) 456-2986
Entity
Organization

Contact information

Practice address
1451 IRVINE BLVD, TUSTIN, CA 92780-3804
(714) 456-7002
(949) 824-2828
Mailing address
PO BOX 513620, LOS ANGELES, CA 90051-3620
(714) 456-6585
(714) 456-8101

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
03/30/2016
Last updated
03/30/2016
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