Organization
CHOC CHILDREN'S UROLOGY CENTER
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 MD (PRESIDENT & CEO)
(714) 456-2986
Entity
Organization
Contact information
Practice address
505 S MAIN ST, SUITE 100, ORANGE, CA 92868-4509
(714) 509-3919
(714) 509-3917
Mailing address
PO BOX 51342, LOS ANGELES, CA 90051-5642
(714) 456-6054
(714) 456-5062
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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